Organization
WYNNES ADULT CARE FACILITY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAROLD DWAYNE WYNNE LPN ADMINISTRATOR (ADMINISTRATOR OWNER)
(434) 385-5815
Entity
Organization
Contact information
Practice address
1565 COTTONTOWN RD, LYNCHBURG, VA 24503-4957
(434) 385-5815
(434) 385-4347
Mailing address
1565 COTTONTOWN RD, LYNCHBURG, VA 24503-4957
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
52001001
VA
Other
Enumeration date
09/26/2006
Last updated
06/23/2008
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