Provider Demographics
NPI:1093817207
Name:LAWSONS FAMILY CARE 3
Entity Type:Organization
Organization Name:LAWSONS FAMILY CARE 3
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LEA
Authorized Official - Middle Name:O
Authorized Official - Last Name:GWYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-349-3610
Mailing Address - Street 1:5860 HIGHWAY BUSINESS 29
Mailing Address - Street 2:P.O. BOX 2361
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27323
Mailing Address - Country:US
Mailing Address - Phone:336-342-3968
Mailing Address - Fax:
Practice Address - Street 1:5860 HIGHWAY BUSINESS 29
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27323
Practice Address - Country:US
Practice Address - Phone:336-342-3968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-079-012310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7805469OtherEDS NUMBER