Organization
LAKE COUNTRY AREA AGENCY ON AGING
Active
Organization
LAKE COUNTRY AREA AGENCY ON AGING
Active
Other names
LCAAA
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GWEN HINZMAN (PRESIDENT/CEO)
(434) 447-7661
Entity
Organization
Contact information
Practice address
1105 W DANVILLE ST, SOUTH HILL, VA 23970-3501
(434) 447-7661
(434) 447-4074
Mailing address
1105 W DANVILLE ST, SOUTH HILL, VA 23970-3501
(434) 447-7661
(434) 447-4074
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
ADC782951
VA
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
3747P1801X
Personal Care Attendant
HC0-17668
VA
385H00000X
Respite Care
HC0-17668
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9114629
—
VA
Enumeration date
10/31/2006
Last updated
07/17/2017
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