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General NPI Number Information
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NPI Number | 1477345957
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Entity Type | Organization
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Legal Business Name | MI CASA CARE HOMES - TYLER LLC
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 968 N TYLER RD
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City | WICHITA
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State | KS
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Zip | 67212-3240
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Country | US
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Telephone | 316-777-6655
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Fax |
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Provider Business Mailing Address
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Address Line | 902 W 29TH ST N STE 102
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City | WICHITA
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State | KS
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Zip | 67204-4809
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Country | US
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Telephone | 316-777-6655
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MONICA MORALES
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Credential | PMHNP-BC
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Telephone | 316-258-3111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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