Provider Demographics
NPI:1982905956
Name:CASA P.R.A.C., INC
Entity Type:Organization
Organization Name:CASA P.R.A.C., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:MELENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-692-2331
Mailing Address - Street 1:800 E CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-5704
Mailing Address - Country:US
Mailing Address - Phone:856-692-2331
Mailing Address - Fax:856-691-9521
Practice Address - Street 1:800 E CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-5704
Practice Address - Country:US
Practice Address - Phone:856-692-2331
Practice Address - Fax:856-691-9521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherCOMMUNITY SOCIAL SERVICE AGENCY