Pine Grove Opco LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

PINE GROVE OPCO LLC

Doing business as

Pine Grove

Practice address

1500 Chestnut Rd
Elgin, SC 29045-9022

Phone

(803) 438-3011

NPI assigned

Jan 7, 2022

Last updated

Jan 7, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

PINE GROVE OPCO LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Doris Singleton

Title

Executive Director

Phone

(803) 438-3011

Specialties & licenses 1

Addresses

Other names 1

• Pine Grove Doing business as

Part of

Pine Grove Opco LLC

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641513600000",
    "number": "1053072470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "ELGIN",
            "state": "SC",
            "postal_code": "290450100",
            "telephone_number": "803-438-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CHESTNUT RD",
            "city": "ELGIN",
            "state": "SC",
            "postal_code": "290459022",
            "telephone_number": "803-438-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE GROVE OPCO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PINE GROVE OPCO LLC",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A",
        "authorized_official_last_name": "SINGLETON",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "803-438-3011"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Grove",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Smith Paschal, PHARMD
• Manish Prafulla Patel, M.D.
• Patient Centered Healthcare LLC (Nurse Next Door Columbia)
• Elite Pierre
• Pine Grove Inc.
• Aleisha Pittman
• Pontiac Pharmacy
• Susan M Postmus, P.T.
• Hollie Powell, MSPAS, PA-C
• Practice Performance Group LLC

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Elgin, SC
• Providers in Elgin, SC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.