Pine Grove Adult Home& Care, Inc | |
2609 North Garden Lane Noth Garden VA 22959 | |
(434) 295-4408 | |
(434) 295-1185 |
Full Name | Pine Grove Adult Home& Care, Inc |
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Speciality | Clinic/center - Adult Mental Health |
Location | 2609 North Garden Lane, Noth Garden, Virginia |
Authorized Official Name and Position | Vincent Leroy Jones (PRESIDENT) |
Authorized Official Contact | 4345311008 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Pine Grove Adult Home& Care, Inc 2609 North Garden Lane Noth Garden VA 22959 Ph: (434) 295-4408 | Pine Grove Adult Home& Care, Inc 2609 North Garden Lane Noth Garden VA 22959 Ph: (434) 295-4408 |
NPI Number | 1740683671 |
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Provider Enumeration Date | 10/07/2014 |
Last Update Date | 10/07/2014 |
Identifier | Type | State | Issuer |
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1740683671 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0850X | Clinic/center - Adult Mental Health | ALF1078422 (Virginia) | Primary |