# LYNNS CARE HOME AT SANDY FORKS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598421984
- **Authorized official:** ANN MARIE CASSELLA (ADMINISTRATOR)
- **Authorized official phone:** (919) 621-9670

## Contact information

- **Practice address:** 6809 SANDY FORKS RD, RALEIGH, NC 27615-7318
- **Practice address phone:** (919) 621-9670
- **Practice address fax:** (919) 516-0796
- **Mailing address:** PO BOX 10215, RALEIGH, NC 27605-0215
- **Mailing address phone:** (919) 621-9670
- **Mailing address fax:** (919) 516-0796

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 11/10/2021
- **Last updated:** 08/19/2025