Pine Tree Villa

LBN: Covington House Of Raleigh,Llc
Pine Tree Villa is an health care organization with primary practice located at 4510 Duraleigh Rd , Raleigh NC 27612-3534. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Covington House Of Raleigh,Llc can be contacted via phone (919) 791-1981, or through Trefzger, Charlie E via phone (828) 324-8898.

Contact Information

Primary practice address
4510 Duraleigh Rd Raleigh NC 27612-3534
Phone: (919) 791-1981
Fax: (919) 791-1986
Website:
Map and Directions
Authorized official contact:
Name: Trefzger, Charlie E
Phone: (828) 324-8898

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X HAL-092-121 North Carolina

Profile Details

NPI number 1205902079
LBN Legal business name Covington House Of Raleigh,Llc
DBA Doing business as Pine Tree Villa
Authorized official Trefzger, Charlie E
Entity Organization
Organization subpart 1 No
Enumeration date Nov 25th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205902079 NPPES
North Carolina MEDICAID 7805597

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