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General NPI Number Information
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NPI Number | 1861385080
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Entity Type | Organization
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Legal Business Name | CASSA PLACE, LLC
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 110 E REYNOLDS ST STE 802
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City | PLANT CITY
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State | FL
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Zip | 33563-3371
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Country | US
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Telephone | 813-666-4060
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Fax |
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Provider Business Mailing Address
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Address Line | 504 W CHERRY ST
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City | PLANT CITY
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State | FL
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Zip | 33563-2314
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Country | US
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Telephone | 813-446-3236
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Fax |
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Authorized Official
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Title or Position | PSYCH NURSE PRACTITIONER/OWNER
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Name | CASSANDRA ROSEBRAUGH
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Credential | APRN, PMHNP-BC
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Telephone | 813-666-4060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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