Lgtula,LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

LGTULA,LLC

Practice address

1515 N Bentalou St
Baltimore, MD 21216-4120

Phone

(410) 702-0510

NPI assigned

Jun 28, 2024

Organization subpart

No

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

Authorized official

Name

Rebecca Yvette JacksonNPI 1649876749

Title

Surrogate

Phone

(443) 418-4254

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rebecca Yvette Jackson, NP

  • Family Nurse Practitioner
  • Baltimore, MD
  • NPI 1649876749
  NPD Authorized official

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1053156166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N BENTALOU ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212164120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N BENTALOU ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212164120",
            "telephone_number": "410-702-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LGTULA,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "YVETTE",
        "authorized_official_title_or_position": "SURROGATE",
        "authorized_official_telephone_number": "443-418-4254"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Jo Leydig, RN
• Steven D Leydorf, MD
• Bianca Leyva-Downs
• Francisco Jose Leyva, M.D., PH.D.
• LG Wellness LLC
• LHC House of Refuge
• LHCG Ccxxiv, LLC
• LHCG Lxxxi, LLC
• LHCG Lxxxi, LLC
• Alex Hongzhe Li, M.D

• Mental Illness Community Based Residential Treatment Facility in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Mental Illness Community Based Residential Treatment Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.