Healthcare Provider Details

I. General information

NPI: 1477343200
Provider Name (Legal Business Name): CASA CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 MADISON ST
WORCESTER MA
01608-2058
US

IV. Provider business mailing address

90 MADISON ST
WORCESTER MA
01608-2058
US

V. Phone/Fax

Practice location:
  • Phone: 774-502-3359
  • Fax:
Mailing address:
  • Phone: 774-502-3359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: LUISANNA RODRIGUEZ
Title or Position: CEO
Credential:
Phone: 774-502-3359