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Organization

LYNNS CARE HOME AT SANDY FORKS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANN MARIE CASSELLA (ADMINISTRATOR)
(919) 621-9670
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary

Other

Enumeration date
11/10/2021
Last updated
08/19/2025
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