Provider Demographics
NPI:1326286402
Name:LAJILCO VENTURES LLC
Entity Type:Organization
Organization Name:LAJILCO VENTURES LLC
Other - Org Name:YOUNG CHIROPRACTIC CLINIC & NORTHWEST SPINAL DECOMPRESSION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-370-4491
Mailing Address - Street 1:17425 STUEBNER AIRLINE RD STE C
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3708
Mailing Address - Country:US
Mailing Address - Phone:281-370-4491
Mailing Address - Fax:281-370-4492
Practice Address - Street 1:17425 STUEBNER AIRLINE RD STE C
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3708
Practice Address - Country:US
Practice Address - Phone:281-370-4491
Practice Address - Fax:281-370-4492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-28
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5725261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center