Provider Demographics
NPI:1033307830
Name:VITRA HEALTH AND HUMAN SERVICES LLC
Entity Type:Organization
Organization Name:VITRA HEALTH AND HUMAN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:ALISIA
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:214-497-6746
Mailing Address - Street 1:2736 DENALI PARK DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-1309
Mailing Address - Country:US
Mailing Address - Phone:214-497-6746
Mailing Address - Fax:972-522-2287
Practice Address - Street 1:2736 DENALI PARK DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-1309
Practice Address - Country:US
Practice Address - Phone:214-497-6746
Practice Address - Fax:972-522-2287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-06
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management