Mystic Meadow Group Home, LLC

NPI #1528347358 in Lynchburg, Virginia

Provider Information

NPI Number
1528347358
Entity Type
Organization
Organization Name
Mystic Meadow Group Home, LLC
Primary Specialty
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date
Aug 10, 2011
Last Updated
Aug 10, 2011

Practice Location

Address
2157 CAMPBELL AVE
ZIP Code
24501-6405
Phone
(434) 847-2001

Authorized Official

Name
MRS. VALERIE A ELLIOTT
Title
PRESIDENT
Phone
(434) 847-2001

Specialties & Taxonomy Codes

Specialty
Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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