Organization
CITAGROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. YINKA LAWAL (MD)
(804) 720-5164
Entity
Organization
Contact information
Practice address
13355 CASTLEWELLAN DR, CHESTER, VA 23836-2904
(804) 720-5164
Mailing address
13355 CASTLEWELLAN DR, CHESTER, VA 23836-2904
(804) 720-5164
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174094759
—
VA
Enumeration date
03/01/2019
Last updated
11/26/2024
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