Provider Demographics
NPI:1386118016
Name:LAJ, INC.
Entity type:Organization
Organization Name:LAJ, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAYME
Authorized Official - Middle Name:M
Authorized Official - Last Name:FROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-289-9662
Mailing Address - Street 1:5051 PAY IT FORWARD DR APT 201
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-4514
Mailing Address - Country:US
Mailing Address - Phone:308-289-9662
Mailing Address - Fax:888-638-3941
Practice Address - Street 1:295 5TH STREET
Practice Address - Street 2:SUITE 8
Practice Address - City:FAIRPLAY
Practice Address - State:CO
Practice Address - Zip Code:80440
Practice Address - Country:US
Practice Address - Phone:308-289-9662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health