Organization
MI CASA ES SU CASA INC
Active
Parent organization
MI CASA ES SU CASA INC
Other names
MI CASA ES SU CASA INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MI CASA ES SU CASA INC
Authorized official
CARLTON TYRONE CARRINGTON (EXECUTIVE DIRECTOR)
(443) 708-8381
Entity
Organization
Contact information
Practice address
3921 OLD YORK RD, BALTIMORE, MD 21218-1910
(443) 563-6280
Mailing address
3921 OLD YORK RD, BALTIMORE, MD 21218-1910
(443) 563-6280
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH001393
BEHAV HLTH ADMIN
MD
Enumeration date
01/02/2019
Last updated
01/02/2019
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