CASA NOVA ICF/DD-H NPI 1982876702

NPI Information

NPI: 1982876702
Provider Name: CASA NOVA ICF/DD-H
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
3937 CASANOVA DR
SAN MATEO, CA
ZIP 94403
Phone: (650) 341-9620
Get Directions

CASA NOVA ICF/DD-H is a residential treatment facility, intellectual and/or developmental disabilities in San Mateo, CA. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. CASA NOVA ICF/DD-H NPI is 1982876702. The provider is registered as an organization entity type.

The provider's business location address is:

3937 CASANOVA DR
SAN MATEO, CA
ZIP 94403-614
Phone: (650) 341-9620
Fax: (650) 525-1167

The provider's authorized official is Yolanda Ruiz .
The authorized official title is Licensee/cfo and has the following contact phone number (650) 303-0788.

The enumeration date for this NPI number is 4/1/2008 and was last updated on 4/1/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities			CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	LTC 60829F	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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