Provider Demographics
NPI:1427592963
Name:CARISSA GROUP INC.
Entity Type:Organization
Organization Name:CARISSA GROUP INC.
Other - Org Name:CARISSA HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SARBJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-815-7412
Mailing Address - Street 1:1048 STOWELL RANCH CIR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-4739
Mailing Address - Country:US
Mailing Address - Phone:909-815-7412
Mailing Address - Fax:951-278-2957
Practice Address - Street 1:1048 STOWELL RANCH CIR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-4739
Practice Address - Country:US
Practice Address - Phone:909-815-7412
Practice Address - Fax:951-278-2957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-16
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities