Organization · Type 2 NPI

State of California - Department of Developmental Services

Intellectual Disabilities Intermediate Care Facility · Cathedral City, CA

NPI number 1730130097 Active

Practice location

69696 Ramon Rd
Cathedral City, CA 92234-3353

Call (760) 770-6200 Map

Fax (760) 328-2769

Mailing address

1215 O Street, Cfs: Ms 10-30
Sacramento, CA 95814

Specialties and licenses

Taxonomy	Code	License
Nursing Facility/Intermediate Care Facility	313M00000X	170000774 (CA)
Intellectual Disabilities Intermediate Care Facility Primary	315P00000X	170000774 (CA)
Intellectual Disabilities Intermediate Care Facility	315P00000X	None listed
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	320900000X	170000774 (CA)
Pharmacy	333600000X	170000774 (CA)

Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.

NPI record

NPI: 1730130097
Entity type: Organization (Type 2)
Issued: May 12, 2006
Last updated: Jun 29, 2021
Status: Active

Other names

<unavail>
Canyon Springs Community Facility · doing business as
Canyon Springs Community Facility · doing business as

Authorized official

Carla A Castaneda
Chief Deputy Director
(916) 654-2822

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1730130097

State of California - Department of Developmental Services's National Provider Identifier is 1730130097, issued on May 12, 2006. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Cathedral City, CA. The record was last updated on Jun 29, 2021.