Pine Ridge Care & Rehabilitation Center
LBN: Hqm Of Pine Ridge, Llc
Pine Ridge Care & Rehabilitation Center is an health care organization with primary practice located at 1200 Spruce Ln Carter County, Elizabethton TN 37643-4301. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, Nursing & Custodial Care Facilities / Skilled Nursing Facility. Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility is the primary health care specialty.
Hqm Of Pine Ridge, Llc can be contacted via phone (423) 543-3202, or through Walczak, Paul via phone (561) 627-0664.
Contact Information
Primary practice address
1200 Spruce Ln Carter County
Elizabethton TN 37643-4301
Phone: (423) 543-3202
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility | 313M00000X | 0027 | Tennessee |
| Nursing & Custodial Care Facilities / Skilled Nursing Facility | 314000000X | 0027 | Tennessee |
Profile Details
| NPI number | 1992784490 |
|---|---|
| LBN Legal business name | Hqm Of Pine Ridge, Llc |
| DBA Doing business as | Pine Ridge Care & Rehabilitation Center |
| Authorized official | Walczak, Paul |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 12th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992784490 | NPPES |
| Tennessee | MEDICAID | 7440568 | |
| Tennessee | MEDICAID | 0445217 |
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