Pine Grove Group Home, Llc

LBN: Pine Grove Group Home, Llc
Pine Grove Group Home, Llc is an health care organization with primary practice located at 4116 Red Hill School Rd , North Garden VA 22959-1733. The organization recently has 2 registered licenses in different health care specialties including Other Service Providers / Meals, Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities is the primary health care specialty. Pine Grove Group Home, Llc can be contacted via phone (434) 295-1615, or through Jones, Stephanie Jane via phone (434) 981-4052.

Contact Information

Primary practice address
4116 Red Hill School Rd North Garden VA 22959-1733
Phone: (434) 295-1615
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Jones, Stephanie Jane RMA
Phone: (434) 981-4052

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Meals 174200000X
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X 069801001 Virginia

Profile Details

NPI number 1922519826
LBN Legal business name Pine Grove Group Home, Llc
DBA Doing business as
Authorized official Jones, Stephanie Jane RMA
Entity Organization
Organization subpart 1 No
Enumeration date Oct 18th, 2017
Last updated Jun 16th, 2018 - about 8 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 1922519826 NPPES
Virginia Other 0269801001 PROVIDER
Virginia Other 0269801001 PROVIDER

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