Provider Demographics
NPI:1467135475
Name:CASA TERESA, INC.
Entity Type:Organization
Organization Name:CASA TERESA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-538-4860
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92856-6429
Mailing Address - Country:US
Mailing Address - Phone:714-538-4860
Mailing Address - Fax:714-744-6409
Practice Address - Street 1:123 W MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-1410
Practice Address - Country:US
Practice Address - Phone:714-538-4860
Practice Address - Fax:714-744-6409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management