Provider Demographics
NPI:1033293089
Name:LEXINGTON COURT LLC
Entity type:Organization
Organization Name:LEXINGTON COURT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GRAHAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:ADELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-521-0550
Mailing Address - Street 1:12093 GAYTON RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-3401
Mailing Address - Country:US
Mailing Address - Phone:804-521-0550
Mailing Address - Fax:804-521-0555
Practice Address - Street 1:1776 CAMBRIDGE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-3203
Practice Address - Country:US
Practice Address - Phone:804-741-6174
Practice Address - Fax:804-740-6189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VANH2505314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA442237OtherBLUECROSS BLUESHIELD PR#
VA004952723Medicaid
VA442237OtherBLUECROSS BLUESHIELD PR#