MEDICARE: LA CASA, 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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1689749046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LA CASA, INC.

Provider Business Mailing Address
First Line	:	P.O. BOX 72922
Second Line	:
City	:	N. CHESTERFIELD
State	:	VA
Zip	:	23235-2922
Country	:	US
Telephone Number	:	804-353-0461
Fax Number	:	804-497-7401

Provider Business Practice Location Address
First Line	:	5621 BACKWATER TERRACE
Second Line	:
City	:	N. CHESTERFIELD
State	:	VA
Zip	:	23234
Country	:	US
Telephone Number	:	804-353-0461
Fax Number	:	804-497-7401

Authorized Official
Title or Position	:	VP/COO
Name	:	TIA LASHE' HICKSON
Credential	:
Telephone Number	:	804-353-0461

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	06/04/2019

Similar Medicare Providers

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1467808923 — DONNELL FONVILLE
Practice Location Address:

4137 WOODFIELD RD
N CHESTERFIELD, VA
23234

Practice Phone: 804-229-5353
Practice Fax: 804-859-7921

1043855687 — LATRICE CLARK
Practice Location Address:

5226 WHETSTONE RD
N CHESTERFLD, VA
23234-4324

Practice Phone: 336-866-9248
Practice Fax:

1942033444 — TAILORED HOLISTIC COUNSELING LLC
Practice Location Address:

6601 IRONGATE SQ STE C
NORTH CHESTERFIELD, VA
23234-6077

Practice Phone: 703-399-2197
Practice Fax:

1043934151 — DANIELLE THOMPSON LPC
Practice Location Address:

6601 IRONGATE SQ STE C
NORTH CHESTERFIELD, VA
23234-6077

Practice Phone: 703-399-2197
Practice Fax:

1093700056 — SARA M BREEDEN MD
Practice Location Address:

6439 IRON BRIDGE RD
NORTH CHESTERFIELD, VA
23234-5205

Practice Phone: 804-271-8990
Practice Fax: 804-271-9020

Directions to “LA CASA, INC. ” 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 © 2007-2025 (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.