MEDICARE: CASAS GROUP HOME INC

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	311Z00000X	Custodial Care Facility

General Provider Information

NPI Number	:	1215108816
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CASAS GROUP HOME INC

Provider Business Mailing Address
First Line	:	1388 SW 143RD PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33184-3218
Country	:	US
Telephone Number	:	305-551-3503
Fax Number	:	305-226-9733

Provider Business Practice Location Address
First Line	:	1388 SW 143RD PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33184-3218
Country	:	US
Telephone Number	:	305-551-3503
Fax Number	:	305-226-9733

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CARIDAD SUAREZ
Credential	:
Telephone Number	:	305-551-3503

Provider Enumeration Date	:	03/22/2008
Last Update Date	:	03/22/2008

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Directions to “CASAS GROUP HOME INC ” Practice Location

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