NPI 1205851110

Lucas Lodge, LLC

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Portsmouth, VA

Practice location

Address: 1214 County St, Portsmouth, VA 23704-3240
Phone: (757) 397-8200
Fax: (757) 397-8224

Authorised official

Name: Lisa Lucas Burke
Title: Assistant Executive Director
Phone: (757) 397-8200

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X Licence 341-01-001 (VA)

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Virginia →

Registry record

NPI: 1205851110
Entity type: Organization
NPI issued: 12 Jul 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.