Provider Demographics
NPI:1457608291
Name:SOLAZ, LLC
Entity Type:Organization
Organization Name:SOLAZ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDUVIGIS
Authorized Official - Middle Name:MARGARITA
Authorized Official - Last Name:ESTRELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-983-7096
Mailing Address - Street 1:2231 E MILLBROOK RD STE 101
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-1746
Mailing Address - Country:US
Mailing Address - Phone:845-893-7096
Mailing Address - Fax:
Practice Address - Street 1:6512 SIX FORKS RD STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6525
Practice Address - Country:US
Practice Address - Phone:845-893-7096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-10
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty