Provider Demographics
NPI:1760258487
Name:CHILD & ADULT SERVICES CAS LLC
Entity Type:Organization
Organization Name:CHILD & ADULT SERVICES CAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-799-5648
Mailing Address - Street 1:1935 COUNTY ROAD B2 W STE 108
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55113-2781
Mailing Address - Country:US
Mailing Address - Phone:612-799-5648
Mailing Address - Fax:
Practice Address - Street 1:1935 COUNTY ROAD B2 W STE 108
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55113-2781
Practice Address - Country:US
Practice Address - Phone:612-799-5648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center