Provider Demographics
NPI:1083192371
Name:LETIS HOUSE INC
Entity type:Organization
Organization Name:LETIS HOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LATREACE
Authorized Official - Middle Name:R
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:SPHD
Authorized Official - Phone:816-535-0938
Mailing Address - Street 1:8407 BRADLEY CT
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-2228
Mailing Address - Country:US
Mailing Address - Phone:816-535-0938
Mailing Address - Fax:
Practice Address - Street 1:8407 BRADLEY CT
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012-2228
Practice Address - Country:US
Practice Address - Phone:816-535-0938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MON03011251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare