Lucas Lodge, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

341-01-001 Issued in VA

Legal business name

LUCAS LODGE, LLC

Practice address

1214 County St
Portsmouth, VA 23704-3240

Phone

(757) 397-8200

Fax

(757) 397-8224

NPI assigned

Jul 12, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa Lucas Burke

Title

Assistant Executive Director

Phone

(757) 397-8200

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205851110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 COUNTY ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237043240",
            "telephone_number": "757-397-8200",
            "fax_number": "757-397-8224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 COUNTY ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237043240",
            "telephone_number": "757-397-8200",
            "fax_number": "757-397-8224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCAS LODGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "LUCAS",
        "authorized_official_title_or_position": "ASSISTANT EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "757-397-8200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "341-01-001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Michael Lowes, DO
• Jaime Luis Loyola III, MD
• Tonya Lynn Lozier, PA-C
• LRS Clinical Group LLC
• Ann Leigh Lucart, PH.D.
• Emily S Lucas, OTR/L
• Paul Albert Lucha Jr., DO
• James Michael Luchetti, MD, FAAP
• Geoffrey Wayne Ludford, EDD
• Oneil Clinton Lue

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.