# MI CASA ES SU CASA, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962544734
- **Authorized official:** DR. ANTONIO GINES M.D. (CEO)
- **Authorized official phone:** (201) 652-8434

## Contact information

- **Practice address:** 911 E 23RD ST, PATERSON, NJ 07513-1500
- **Practice address phone:** (973) 345-4300
- **Practice address fax:** (973) 345-8811
- **Mailing address:** 30 S MAPLE AVE, RIDGEWOOD, NJ 07450-4508
- **Mailing address phone:** (201) 652-8434
- **Mailing address fax:** (201) 652-0194

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 708110 | NJ | Yes |

## Other

- **Enumeration date:** 02/12/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6799701 | — | NJ |