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Mystic Meadow Group Home, Llc
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Lynchburg, Virginia
NPI 1528347358

Mystic Meadow Group Home, Llc is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Lynchburg, VA. Mystic Meadow Group Home, Llc practices in Lynchburg, VA. The NPI Number for Mystic Meadow Group Home, Llc is 1528347358 and holds a License No. (Virginia).

The current practice location address for Mystic Meadow Group Home, Llc is 2157 Campbell Ave, Lynchburg, VA and can be reached out via phone at 434-847-2001 and via fax at 434-847-2022. You can also correspond with Mystic Meadow Group Home, Llc through the mailing address at 2157 CAMPBELL AVE, LYNCHBURG, VA - 24501-6405 (mailing address contact number: 434-847-2001).

Location: 2157 Campbell Ave, Lynchburg, VA, 24501-6405
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1528347358
Provider Name
Mystic Meadow Group Home, Llc
Credential
Provider Entity Type
Organization
Address
2157 Campbell Ave, Lynchburg, VA, 24501-6405
Phone Number
434-847-2001
Fax Number
434-847-2022
Provider Enumeration Date
08/10/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2157 Campbell Ave
City
Lynchburg
State
Virginia
Zip
24501-6405
Phone Number
434-847-2001
Fax Number
434-847-2022
person
Provider Business Mailing Address Details
Address
2157 Campbell Ave
City
Lynchburg
State
Virginia
Zip
24501-6405
Phone Number
434-847-2001
Fax Number
434-847-2022
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
(Virginia)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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