Provider Demographics
NPI:1689912941
Name:LA CASA FELIZ
Entity Type:Organization
Organization Name:LA CASA FELIZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:VITMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:FELIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-492-2145
Mailing Address - Street 1:PO BOX 58381
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27658-8381
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2200 E MILLBROOK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1788
Practice Address - Country:US
Practice Address - Phone:919-710-3169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty