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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