Organization · NPI-2

Capo Canyon Recovery LLC

Substance Abuse Rehabilitation Facility · Mission Viejo, CA

NPI number1124560297
StatusActive
Last updated in NPPESMay 26, 2020

Details

NPI
1124560297
Entity type
Organization (NPI-2)
Legal business name
Capo Canyon Recovery LLC
Organization subpart
No
Enumeration date
Nov 7, 2016
Certification date
May 26, 2020
Last updated
May 26, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
324500000X Substance Abuse Rehabilitation Facility300359APCAYes

Practice location

26991 El Ciervo Ln
Mission Viejo, CA 92691-6018

Phone 800-804-8714

Mailing address

Po Box 448
San Juan Capistrano, CA 92693-0448

Phone 800-804-8714

Other practice locations

23822 Stillwater Ln
Laguna Niguel, CA 92677-1706

Phone 800-804-8714

Authorized official

Shonte Perluss
Facility Administrator
9492593052

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