Provider Demographics
NPI:1912045923
Name:THE LAWSON GROUP, LLC.
Entity Type:Organization
Organization Name:THE LAWSON GROUP, LLC.
Other - Org Name:ACTIVE WAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-693-7665
Mailing Address - Street 1:3020 W WILLOW KNOLLS DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-8127
Mailing Address - Country:US
Mailing Address - Phone:309-693-7665
Mailing Address - Fax:309-693-7664
Practice Address - Street 1:3020 W WILLOW KNOLLS DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-8127
Practice Address - Country:US
Practice Address - Phone:309-693-7665
Practice Address - Fax:309-693-7664
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE LAWSON GROUP, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-02
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010253251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health