La Mariposa LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

2037 Issued in VA

Legal business name

LA MARIPOSA LLC

Practice address

475 Water St Apt 604
Portsmouth, VA 23704-3899

Phone

(757) 403-0429

NPI assigned

Feb 7, 2013

Last updated

Feb 7, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Gwendolyn Lee Carlisle

Title

Owner/Ceo

Phone

(757) 403-0429

Specialties & licenses 1

Addresses

Tax ID family

La Mariposa LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• La Mariposa, LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Norfolk, VA
  • NPI 1639596273
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360195200000",
    "number": "1275872400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 WATER ST APT 604",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237043899",
            "telephone_number": "757-403-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 WATER ST APT 604",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237043899",
            "telephone_number": "757-403-0429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA MARIPOSA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-07",
        "last_updated": "2013-02-07",
        "status": "A",
        "authorized_official_last_name": "CARLISLE",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "757-403-0429",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "2037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anita S Kush, CRNA
• Trevor Lee Kuttler, MD
• Caroline Kwon
• Adrianna Isabel Kyle, DO
• L.I.F.T Counseling
• Kenneth L Labasky, LCSW
• Danielle Claudette Lacasse
• Erika Nicole Lackey
• Zachary Joseph Lafreniere, DDS
• Nicholas Heller Lake, M.D.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.