Provider Demographics
NPI:1265888622
Name:CASA CONTENTA RECOVERY GROUP, INC.
Entity type:Organization
Organization Name:CASA CONTENTA RECOVERY GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:S
Authorized Official - Last Name:BUCHANAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, IMF 78663
Authorized Official - Phone:714-451-9107
Mailing Address - Street 1:8431 WEIRICK RD
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-4994
Mailing Address - Country:US
Mailing Address - Phone:714-451-9107
Mailing Address - Fax:
Practice Address - Street 1:8431 WEIRICK RD
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92883-4994
Practice Address - Country:US
Practice Address - Phone:714-451-9107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility