Provider Demographics
NPI:1194158758
Name:L & L RESOURCES LLC
Entity type:Organization
Organization Name:L & L RESOURCES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:248-884-6770
Mailing Address - Street 1:3720 ELIZABETH LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-3014
Mailing Address - Country:US
Mailing Address - Phone:248-884-6770
Mailing Address - Fax:
Practice Address - Street 1:3720 ELIZABETH LAKE RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-3014
Practice Address - Country:US
Practice Address - Phone:248-884-6770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-17
Last Update Date:2013-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISA0631357251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health