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General NPI Number Information
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NPI Number | 1225476047
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Entity Type | Organization
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Legal Business Name | LYNN'S PERSONAL CARE HOME
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Dates
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Enumeration Date | 06/14/2013
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Last Update Date | 06/14/2013
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Provider Practice Location Address
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Address Line | 3350 PEACH ORCHARD RD STE 807
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City | AUGUSTA
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State | GA
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Zip | 30906-5932
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Country | US
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Telephone | 706-793-0971
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Fax | 706-793-0950
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Provider Business Mailing Address
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Address Line | 3649 GA HIGHWAY 88
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City | BLYTHE
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State | GA
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Zip | 30805-3620
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Country | US
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Telephone | 706-592-6651
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Fax | 706-793-0950
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MRS. LINDA JEAN CURRY
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Credential | REGISTERED NURSE
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Telephone | 706-631-3169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | PCH008162
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License Number State | GA
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