Organization
MI CASA TRANSITIONAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M PAYNE (ADMINISTRATOR)
(719) 214-4755
Entity
Organization
Contact information
Practice address
1611 CRESTMOOR DR, PUEBLO, CO 81001-2727
(719) 214-4755
Mailing address
1611 CRESTMOOR DR, PUEBLO, CO 81001-2727
(719) 214-4755
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
01/23/2020
Last updated
01/24/2020
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