Provider Demographics
NPI:1861714339
Name:THE ITHIEL GROUP, LLC
Entity type:Organization
Organization Name:THE ITHIEL GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:LUCAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-526-1732
Mailing Address - Street 1:3225 IRVINGTON ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23234-1538
Mailing Address - Country:US
Mailing Address - Phone:804-562-1732
Mailing Address - Fax:804-562-1732
Practice Address - Street 1:3225 IRVINGTON ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23234-1538
Practice Address - Country:US
Practice Address - Phone:804-562-1732
Practice Address - Fax:804-562-1732
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE ITHIEL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities