Provider Demographics
NPI:1265179022
Name:MI CASA CARE HOMES LLC
Entity type:Organization
Organization Name:MI CASA CARE HOMES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:316-777-6655
Mailing Address - Street 1:1999 N AMIDON AVE STE 375
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-2124
Mailing Address - Country:US
Mailing Address - Phone:316-777-6655
Mailing Address - Fax:888-975-7964
Practice Address - Street 1:521 MAIN ST
Practice Address - Street 2:
Practice Address - City:TOWANDA
Practice Address - State:KS
Practice Address - Zip Code:67144-9001
Practice Address - Country:US
Practice Address - Phone:316-777-6655
Practice Address - Fax:888-975-7964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility