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General NPI Number Information
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NPI Number | 1619680386
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Entity Type | Organization
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Legal Business Name | CASA COMPANION HOMECARE LLC
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Dates
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Enumeration Date | 12/27/2022
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Last Update Date | 01/08/2023
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Provider Practice Location Address
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Address Line | 37808 W SANTA BARBARA AVE
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City | MARICOPA
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State | AZ
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Zip | 85138-5416
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Country | US
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Telephone | 502-431-4045
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Fax |
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Provider Business Mailing Address
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Address Line | 37808 W SANTA BARBARA AVE
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City | MARICOPA
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State | AZ
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Zip | 85138-5416
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Country | US
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Telephone | 502-431-4045
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | VICTORIA WANJUHI
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Credential |
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Telephone | 404-974-7010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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