Provider Demographics
NPI:1225476047
Name:LYNN'S PERSONAL CARE HOME
Entity Type:Organization
Organization Name:LYNN'S PERSONAL CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:CURRY
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:706-631-3169
Mailing Address - Street 1:3649 GA HIGHWAY 88
Mailing Address - Street 2:
Mailing Address - City:BLYTHE
Mailing Address - State:GA
Mailing Address - Zip Code:30805-3620
Mailing Address - Country:US
Mailing Address - Phone:706-592-6651
Mailing Address - Fax:706-793-0950
Practice Address - Street 1:3350 PEACH ORCHARD RD STE 807
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-5932
Practice Address - Country:US
Practice Address - Phone:706-793-0971
Practice Address - Fax:706-793-0950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCH008162311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home