Provider Demographics
NPI:1467593608
Name:LA RAZA SERVICES, INC.
Entity Type:Organization
Organization Name:LA RAZA SERVICES, INC.
Other - Org Name:SERVICIOS DE LA RAZA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF BEHAVIORAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:BELEN
Authorized Official - Last Name:VIZOSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-953-5910
Mailing Address - Street 1:3131 W. 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204
Mailing Address - Country:US
Mailing Address - Phone:303-458-5851
Mailing Address - Fax:303-455-1332
Practice Address - Street 1:3131 W. 14TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204
Practice Address - Country:US
Practice Address - Phone:303-458-5851
Practice Address - Fax:303-455-1332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO044-67098Medicaid