MEDICARE: CASA REAL OPCO, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1164379400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CASA REAL OPCO, LLC

Provider Business Mailing Address
First Line	:	9526 W PICO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1202
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 GALISTEO ST
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-4747
Country	:	US
Telephone Number	:	323-928-9445
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE VICE PRESIDENT
Name	:	AVROHOM TRESS
Credential	:
Telephone Number	:	323-928-9445

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

Similar Medicare Providers

1598722894 — ANTHONY ABBATE
Practice Location Address:

1622 GALISTEO ST
SANTA FE, NM
87505-4747

Practice Phone: 505-438-8884
Practice Fax: 505-438-8883

1780883298 — CASA REAL NURSING OPERATIONS LLC
Practice Location Address:

1650 GALISTEO ST
SANTA FE, NM
87505-4747

Practice Phone: 505-984-8313
Practice Fax:

1386888394 — DR. MONICA R. LUNA, LLC
Practice Location Address:

1622 GALISTEO ST
SANTA FE, NM
87505-4747

Practice Phone: 505-231-6236
Practice Fax: 505-424-1426

1487907820 — SF HEALTH FACILITIES - CASA REAL LP
Practice Location Address:

1650 GALISTEO ST
SANTA FE, NM
87505-4747

Practice Phone: 505-984-8313
Practice Fax: 505-984-2542

1497098883 — LEO IWE NWAOKWU FNP
Practice Location Address:

1650 GALISTEO ST
SANTA FE, NM
87505-4747

Practice Phone: 512-287-0444
Practice Fax:

1316324387 — GABRIEL GOVENDO
Practice Location Address:

1622 GALISTEO ST
SANTA FE, NM
87505-4747

Practice Phone: 510-290-4456
Practice Fax:

Directions to “CASA REAL OPCO, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.