Provider Demographics
NPI:1114665825
Name:ALD GROUPS LLC
Entity Type:Organization
Organization Name:ALD GROUPS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CIO
Authorized Official - Prefix:DR
Authorized Official - First Name:PRINCESS CHINYERE
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLIDAY ENYIUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:323-497-7039
Mailing Address - Street 1:206 TEMPLE AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-2864
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:132 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-1604
Practice Address - Country:US
Practice Address - Phone:323-497-7039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No251S00000XAgenciesCommunity/Behavioral Health
No305R00000XManaged Care OrganizationsPreferred Provider OrganizationGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty