Provider Demographics
NPI:1255018271
Name:CASITA HOME CARE LLC
Entity type:Organization
Organization Name:CASITA HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CEPEDA-BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-392-7026
Mailing Address - Street 1:8000 W 122ND ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-1282
Mailing Address - Country:US
Mailing Address - Phone:917-392-7026
Mailing Address - Fax:
Practice Address - Street 1:688 SE BAYBERRY LN STE 103C
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-4392
Practice Address - Country:US
Practice Address - Phone:917-392-7026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care