Healthcare Provider Details

I. General information

NPI: 1982246815
Provider Name (Legal Business Name): CA YA SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2019
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 MARGARITA DR
SAN RAFAEL CA
94901-2329
US

IV. Provider business mailing address

L-4054
COLUMBUS OH
43260-4054
US

V. Phone/Fax

Practice location:
  • Phone: 855-969-9581
  • Fax: 844-721-8190
Mailing address:
  • Phone: 714-202-5166
  • Fax: 844-721-8130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: KEITH THOMPSON
Title or Position: CHIEF LEGAL & DEVELOPMENT OFFICER
Credential:
Phone: 949-432-4622