Pine Leaf Personal Care Home

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

PINE LEAF PERSONAL CARE HOME

Practice address

121 S Elm St
East Dublin, GA 31027-7778

Phone

(478) 575-0083

NPI assigned

Mar 6, 2019

Last updated

Mar 6, 2019By 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

Mrs. Shomankia Pinkston Mills

Title

Director

Phone

(478) 575-0083

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551830400000",
    "number": "1235697483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S ELM ST",
            "city": "EAST DUBLIN",
            "state": "GA",
            "postal_code": "310277778",
            "telephone_number": "478-575-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S ELM ST",
            "city": "EAST DUBLIN",
            "state": "GA",
            "postal_code": "310277778",
            "telephone_number": "478-575-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE LEAF PERSONAL CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-06",
        "last_updated": "2019-03-06",
        "status": "A",
        "authorized_official_last_name": "MILLS",
        "authorized_official_first_name": "SHOMANKIA",
        "authorized_official_middle_name": "PINKSTON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "478-575-0083",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nursing Care Agency in East Dublin, GA
• Providers in East Dublin, GA by specialty
• Nursing Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; 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.