Organization
CASACONNECT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOLENE CUNNINGHAM RN, CCM, CNLCP (PRESIDENT)
(505) 899-5276
Entity
Organization
Contact information
Practice address
3918 VILLA WAY SE, RIO RANCHO, NM 87124-1047
(505) 899-5276
(505) 898-1033
Mailing address
PO BOX 1292, CORRALES, NM 87048-1292
(505) 899-5276
(505) 898-1033
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30028311
—
NM
Enumeration date
03/08/2007
Last updated
08/22/2020
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