# IMMANUEL RESIDENTIAL SERVICES LLC

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

## Provider details

- **NPI number:** 1659894376
- **Authorized official:** CANDICE CAGE (DIRECTOR)
- **Authorized official phone:** (434) 509-9721

## Contact information

- **Practice address:** 1002 WEXFORD PLACE, LYNCHBURG, VA 24502
- **Practice address phone:** (434) 509-9721
- **Mailing address:** 1002 WEXFORD PL, LYNCHBURG, VA 24502-3221
- **Mailing address phone:** (434) 509-9721

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 26880 | VA | Yes |

## Other

- **Enumeration date:** 07/25/2017
- **Last updated:** 07/21/2022