Provider Demographics
NPI:1023054376
Name:CASA-TRINITY, INC.
Entity type:Organization
Organization Name:CASA-TRINITY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTRACTING AND CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:O
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-302-0442
Mailing Address - Street 1:4612 MILLENNIUM DRIVE
Mailing Address - Street 2:
Mailing Address - City:GENESEO
Mailing Address - State:NY
Mailing Address - Zip Code:14454-1418
Mailing Address - Country:US
Mailing Address - Phone:585-443-2018
Mailing Address - Fax:585-991-5013
Practice Address - Street 1:4612 MILLENNIUM DRIVE
Practice Address - Street 2:
Practice Address - City:GENESEO
Practice Address - State:NY
Practice Address - Zip Code:14454-1418
Practice Address - Country:US
Practice Address - Phone:585-443-2018
Practice Address - Fax:585-991-5013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00689689Medicaid
PA103083743Medicaid