Provider Demographics
NPI:1871285569
Name:LUX BEHAVIORAL AND WELLNESS CENTER
Entity type:Organization
Organization Name:LUX BEHAVIORAL AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EUSTACHE
Authorized Official - Suffix:
Authorized Official - Credentials:MS , IN PSYCH
Authorized Official - Phone:978-483-7515
Mailing Address - Street 1:59 TEMPLE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-3270
Mailing Address - Country:US
Mailing Address - Phone:978-483-7515
Mailing Address - Fax:
Practice Address - Street 1:59 TEMPLE ST APT 1
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-3270
Practice Address - Country:US
Practice Address - Phone:978-483-7515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)