Provider Demographics
NPI:1346546652
Name:CASA KAYA, LLC
Entity Type:Organization
Organization Name:CASA KAYA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SYLLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-503-8511
Mailing Address - Street 1:4719 GOLDEN BARREL RD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-5363
Mailing Address - Country:US
Mailing Address - Phone:505-503-8511
Mailing Address - Fax:
Practice Address - Street 1:4719 GOLDEN BARREL RD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-5363
Practice Address - Country:US
Practice Address - Phone:505-503-8511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM03187253000253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care