Organization
INNOVATIVE SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DWAYNE LYNCH (OWNER)
(804) 852-0655
Entity
Organization
Contact information
Practice address
1101 ELECTRIC RD, SALEM, VA 24153-6413
(804) 852-0655
Mailing address
PO BOX 544, NEW CASTLE, VA 24127-0544
(804) 852-0655
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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