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General NPI Number Information
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NPI Number | 1174404875
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Entity Type | Organization
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Legal Business Name | CENTRAL SUPPORT SERVICES, LLC
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Dates
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Enumeration Date | 09/09/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 110 VISTA CENTRE DR STE 21
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City | FOREST
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State | VA
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Zip | 24551-2775
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Country | US
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Telephone | 804-852-0655
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4155
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City | LYNCHBURG
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State | VA
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Zip | 24502-0155
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DWAYNE LYNCH
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Credential |
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Telephone | 804-852-0655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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