Organization
LYNCHBURG AREA CENTER FOR INDEPENDENT LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHIL THEISEN (EXECUTIVE DIRECTOR)
(434) 528-4971
Entity
Organization
Contact information
Practice address
500 ALLEGHANY AVE STE 520, LYNCHBURG, VA 24501-2610
(434) 528-4971
(434) 528-4976
Mailing address
500 ALLEGHANY AVE STE 520, LYNCHBURG, VA 24501-2610
(434) 528-4971
(434) 528-4976
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
VA
Other
Enumeration date
02/08/2007
Last updated
08/22/2020
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