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

3568 Karlin Ave
Norfolk, VA 23502-3111

Phone

(757) 466-9999

Fax

(757) 466-9966

NPI assigned

Mar 20, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Gwendolyn Louise Carlisle

Title

Cvo

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
  • Portsmouth, VA
  • NPI 1275872400
  NPD tax ID

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

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395273600000",
    "number": "1639596273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 WATER ST",
            "address_2": "UNIT 604",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237043819",
            "telephone_number": "757-403-0429",
            "fax_number": "757-466-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3568 KARLIN AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023111",
            "telephone_number": "757-466-9999",
            "fax_number": "757-466-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA MARIPOSA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-20",
        "last_updated": "2014-03-20",
        "status": "A",
        "authorized_official_last_name": "CARLISLE",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "CVO",
        "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": []
}

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• Carol Gerarda La Fauci, NP
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• Arnel Agravante Lacerna, NP
• Sarah Renee Lacour, DPT
• Rhonda L Ladd, LPC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Norfolk, VA
• Providers in Norfolk, 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 Mar 20, 2014; 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.