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NPI Code Detail

MEDICARE: CASA DE LAS AMIGAS

MEDICARE: CASA DE LAS AMIGAS
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
1101YA0400XAddiction (Substance Use Disorder) Counselor190012CNCA
2324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1922276062
Entity Type Code : Organization
Provider Name (Legal Business Name) : CASA DE LAS AMIGAS
Provider Business Mailing Address
First Line : 160 N EL MOLINO AVE
Second Line :
City : PASADENA
State : CA
Zip : 91101
Country : US
Telephone Number : 626-792-2770
Fax Number : 626-792-5826
Provider Business Practice Location Address
First Line : 160 N EL MOLINO AVE
Second Line : 173 NORTH OAK KNOLL AVE
City : PASADENA
State : CA
Zip : 91101-1805
Country : US
Telephone Number : 626-792-2770
Fax Number : 626-792-5826
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MISS LEAH NOEL RODEMICH
Credential :
Telephone Number : 626-792-2770
Provider Enumeration Date : 02/12/2008
Last Update Date : 08/25/2016

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Directions to “CASA DE LAS AMIGAS ” Practice Location

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