NPI 1275872400

La Mariposa LLC

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Portsmouth, VA

Practice location

Address: 475 Water St APT 604, Portsmouth, VA 23704-3899
Phone: (757) 403-0429

Authorised official

Name: Gwendolyn Lee Carlisle
Title: Owner/Ceo
Phone: (757) 403-0429

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X Licence 2037 (VA)

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Virginia →

Registry record

NPI: 1275872400
Entity type: Organization
NPI issued: 7 Feb 2013
Record last updated: 7 Feb 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.