Provider Demographics
NPI:1750701462
Name:LSG AND ASSOCIATES LLC
Entity type:Organization
Organization Name:LSG AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN GALLEGOS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:505-250-5204
Mailing Address - Street 1:600 CAMINO ESPANOL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-5817
Mailing Address - Country:US
Mailing Address - Phone:505-250-5204
Mailing Address - Fax:505-345-4450
Practice Address - Street 1:600 CAMINO ESPANOL NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-5817
Practice Address - Country:US
Practice Address - Phone:505-250-5204
Practice Address - Fax:505-345-4450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services