Organization
MI CASA ES SU CASA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRI FIELDS CPAT (CREDENTIALING/BILLING CONSULTANT)
(443) 559-0405
Entity
Organization
Contact information
Practice address
3921 OLD YORK RD, BALTIMORE, MD 21218-1910
(443) 219-7855
Mailing address
3921 OLD YORK RD, BALTIMORE, MD 21218-1910
(443) 219-7855
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/29/2015
Last updated
12/15/2015
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