Organization
LAURALEX, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALJANON WILLS (DIRECTOR)
(804) 358-9300
Entity
Organization
Contact information
Practice address
12516 RIVER RD, RICHMOND, VA 23238-6135
(804) 358-9300
Mailing address
12516 RIVER RD, RICHMOND, VA 23238-6135
(804) 358-9300
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
991-01-001
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
991
—
VA
05
—
991-01-001
—
VA
Enumeration date
04/16/2008
Last updated
06/25/2008
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