Organization
GRACE STREET ASSOCIATES
Active
Other names
Grace Lodge
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN E. WOOTEN LNHA (ADMINISTRATOR)
(434) 528-0969
Entity
Organization
Contact information
Practice address
1503 GRACE ST, LYNCHBURG, VA 24504-3211
(434) 528-0969
(434) 846-3549
Mailing address
1503 GRACE ST, LYNCHBURG, VA 24504-3211
(434) 528-0969
(434) 846-3549
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
RO06002
VA
313M00000X
Nursing Facility/Intermediate Care Facility
NH2561
VA
Other
Enumeration date
10/10/2006
Last updated
09/11/2025
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