Pine Vale Inc

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

PINE VALE INC

Doing business as

Pine Vale Childrens Home

Practice address

1872 County Road 700
Corinth, MS 38834-8734

Phone

(662) 286-6555

Fax

(662) 287-0283

NPI assigned

Jun 24, 2011

Last updated

Jun 24, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Baragona

Title

Director

Phone

(662) 286-6555

Specialties & licenses 1

Addresses

Other names 1

• Pine Vale Childrens Home Doing business as

Tax ID family

Pine Vale Children's Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pine Vale Children's Home

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Corinth, MS
  • NPI 1184077364
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sheila Bell Beaty

  • Mental Health Counselor
  • Corinth, MS
  • NPI 1639260961
  NPD (past)

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308873600000",
    "number": "1225324510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1872 COUNTY ROAD 700",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388348734",
            "telephone_number": "662-286-6555",
            "fax_number": "662-287-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1872 COUNTY ROAD 700",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388348734",
            "telephone_number": "662-286-6555",
            "fax_number": "662-287-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE VALE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-24",
        "last_updated": "2011-06-24",
        "status": "A",
        "authorized_official_last_name": "BARAGONA",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "662-286-6555",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Vale Childrens Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Physicians Urgent Care of Corinth, LLC (Urgent Care of Corinth)
• Physicians Urgent Care of Corinth, LLC
• Jennifer Elaine Pickens, FNP-BC
• Nanni Pidikiti, M.D.
• Pine Vale Children's Home
• Alisha Pinner
• David V Pizzimenti, DO
• Brittney Leeann Plunk, FNP-C
• Terry Plunk, FNP-BC
• Mary Avery Poole, DO

• Emotionally Disturbed Childrens' Residential Treatment Facility in Corinth, MS
• Providers in Corinth, MS by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; 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.