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General NPI Number Information
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NPI Number | 1659000321
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Entity Type | Organization
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Legal Business Name | THE LEXUS BROWN FOUNDATION INC
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Dates
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Enumeration Date | 06/08/2022
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Last Update Date | 06/08/2022
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Provider Practice Location Address
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Address Line | 437 PARK ST
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City | BRIDGEPORT
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State | CT
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Zip | 06608-1408
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Country | US
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Telephone | 203-753-2400
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Fax | 203-290-4152
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Provider Business Mailing Address
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Address Line | 1000 LAFAYETTE BLVD STE 1100
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City | BRIDGEPORT
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State | CT
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Zip | 06604-4710
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Country | US
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Telephone | 203-753-2400
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Fax | 203-290-4152
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. SHANISA HUDSON
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Credential |
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Telephone | 203-753-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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