Provider Demographics
NPI:1346873007
Name:CASA PEDIATRIC CARE LLC
Entity Type:Organization
Organization Name:CASA PEDIATRIC CARE LLC
Other - Org Name:CASA PEDIATRIC CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, SLP
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:479-220-1847
Mailing Address - Street 1:644 W OAKLAWN DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-7068
Mailing Address - Country:US
Mailing Address - Phone:479-220-1847
Mailing Address - Fax:
Practice Address - Street 1:644 W OAKLAWN DR
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-7068
Practice Address - Country:US
Practice Address - Phone:479-220-1847
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-20
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty