Provider Demographics
NPI:1639291131
Name:CASA, INC
Entity Type:Organization
Organization Name:CASA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:D
Authorized Official - Last Name:WALP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-879-6165
Mailing Address - Street 1:PO BOX 150
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04098-0150
Mailing Address - Country:US
Mailing Address - Phone:207-879-6165
Mailing Address - Fax:207-879-7466
Practice Address - Street 1:741 WARREN AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-1007
Practice Address - Country:US
Practice Address - Phone:207-879-6165
Practice Address - Fax:207-879-7466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Not Answered315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities