Provider Demographics
NPI:1841896065
Name:LA RAZA SERVICES, INC.
Entity type:Organization
Organization Name:LA RAZA SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
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:80204-2203
Mailing Address - Country:US
Mailing Address - Phone:303-953-5917
Mailing Address - Fax:
Practice Address - Street 1:490 W COLFAX AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-2607
Practice Address - Country:US
Practice Address - Phone:303-458-5851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-11
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000167581Medicaid