Provider Demographics
NPI:1346935806
Name:CITAGROUP LLC
Entity Type:Organization
Organization Name:CITAGROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:YINKA
Authorized Official - Middle Name:T
Authorized Official - Last Name:LAWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-720-5164
Mailing Address - Street 1:13355 CASTLEWELLAN DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-2904
Mailing Address - Country:US
Mailing Address - Phone:804-720-5164
Mailing Address - Fax:
Practice Address - Street 1:13355 CASTLEWELLAN DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-2904
Practice Address - Country:US
Practice Address - Phone:804-720-5164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities