Pinehouse, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL9863 Issued in FL

Legal business name

PINEHOUSE, INC.

Doing business as

OakRidge Assisted Living Facility

Practice address

297 SW County Road 300
Mayo, FL 32066-4402

Phone

(386) 294-5050

Fax

(386) 294-5057

NPI assigned

Feb 15, 2006

Last updated

May 19, 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. Waymon W. Thomas

Title

President

Phone

(386) 294-5050

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• OakRidge Assisted Living Facility Doing business as

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305763200000",
    "number": "1306810403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 SW COUNTY ROAD 300",
            "city": "MAYO",
            "state": "FL",
            "postal_code": "320664402",
            "telephone_number": "386-294-5050",
            "fax_number": "386-294-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 SW COUNTY ROAD 300",
            "city": "MAYO",
            "state": "FL",
            "postal_code": "320664402",
            "telephone_number": "386-294-5050",
            "fax_number": "386-294-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEHOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2011-05-19",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "WAYMON",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-294-5050",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL9863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140629900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "678902100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OakRidge Assisted Living Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Mayo, FL
• Providers in Mayo, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.