institution
Lucas Lodge, Llc
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Portsmouth, Virginia
NPI 1205851110

Lucas Lodge, Llc is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Portsmouth, VA. Lucas Lodge, Llc practices in Portsmouth, VA. The NPI Number for Lucas Lodge, Llc is 1205851110 and holds a License No. 341-01-001 (Virginia).

The current practice location address for Lucas Lodge, Llc is 1214 County St, Portsmouth, VA and can be reached out via phone at 757-397-8200 and via fax at 757-397-8224. You can also correspond with Lucas Lodge, Llc through the mailing address at 1214 COUNTY ST, PORTSMOUTH, VA - 23704-3240 (mailing address contact number: 757-397-8200).

Location: 1214 County St, Portsmouth, VA, 23704-3240
institution
Provider Profile Details
NPI Number
1205851110
Provider Name
Lucas Lodge, Llc
Credential
Provider Entity Type
Organization
Address
1214 County St, Portsmouth, VA, 23704-3240
Phone Number
757-397-8200
Fax Number
757-397-8224
Provider Enumeration Date
07/12/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1214 County St
City
State
Zip
23704-3240
Phone Number
757-397-8200
Fax Number
757-397-8224
person
Provider Business Mailing Address Details
Address
1214 County St
City
State
Zip
23704-3240
Phone Number
757-397-8200
Fax Number
757-397-8224
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
341-01-001 (Virginia)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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