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General NPI Number Information
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NPI Number | 1760513741
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Entity Type | Organization
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Legal Business Name | CASACONNECT, LLC
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3918 VILLA WAY SE
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City | RIO RANCHO
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State | NM
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Zip | 87124-1047
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Country | US
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Telephone | 505-899-5276
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Fax | 505-898-1033
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Provider Business Mailing Address
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Address Line | PO BOX 1292
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City | CORRALES
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State | NM
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Zip | 87048-1292
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Country | US
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Telephone | 505-899-5276
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Fax | 505-898-1033
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. JOLENE CUNNINGHAM
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Credential | RN, CCM, CNLCP
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Telephone | 505-899-5276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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