Lucas Lodge, Llc

NPI 1205851110 - Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities - 320900000X

NPI Details
NPI 1205851110
Enumeration Date 07/12/2006
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name LISA LUCAS LISA
Position ASSISTANT EXECUTIVE DIRECTOR
Phone (757) 397-8200
Fax (757) 397-8224
Practice Location
1214 COUNTY ST
PORTSMOUTH VA, 23704-3240, US
Phone (757) 397-8200
Fax (757) 397-8224
Business Location
1214 COUNTY ST
PORTSMOUTH VA, 23704-3240, US
Phone (757) 397-8200
Fax (757) 397-8224
Toxanomy
Taxonomy Code 320900000X
License State Virginia
License Number 341-01-001
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According to our database, Lucas Lodge, Llc NPI is 1205851110, taxonomy code is 320900000X and license number is 341-01-001, license state is located at Virginia. Lucas Lodge, Llc physically located at 1214 County St, Portsmouth VA, 23704-3240. NPI Number 1033115704 has the healthcare provider type.

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1205851110 NPI number is provided on an as is basis without warranty of any kind. 1205851110 is maintained by the National Plan & Provider Enumeration System. The contents of Lucas Lodge, Llc are for informational purposes only.