Provider Demographics
NPI:1659000321
Name:THE LEXUS BROWN FOUNDATION INC
Entity Type:Organization
Organization Name:THE LEXUS BROWN FOUNDATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-753-2400
Mailing Address - Street 1:1000 LAFAYETTE BLVD STE 1100
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06604-4710
Mailing Address - Country:US
Mailing Address - Phone:203-753-2400
Mailing Address - Fax:203-290-4152
Practice Address - Street 1:437 PARK ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06608-1408
Practice Address - Country:US
Practice Address - Phone:203-753-2400
Practice Address - Fax:203-290-4152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging