Provider Demographics
NPI:1104106947
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:
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:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME623144251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health