Organization
MI CASA INC
Active
Other names
Mi Casa Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY K BOATRIGHT (VP COO)
(678) 261-3665
Entity
Organization
Contact information
Practice address
2271 BRENGARE DR, DECATUR, GA 30033-4711
(678) 261-3665
(866) 383-4655
Mailing address
2271 BRENGARE DR, DECATUR, GA 30033-4711
(678) 261-3665
(866) 383-4655
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
044-R-0199
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044-R-0199
GA DEPT OF HR LICENSE
GA
Enumeration date
03/28/2007
Last updated
08/22/2020
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