Pine Grove Adult Home. Inc

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

IR000055 Issued in VA

Legal business name

PINE GROVE ADULT HOME. INC

Practice address

2609 N Garden LN
North Garden, VA 22959-1636

Phone

(434) 531-1008

NPI assigned

Apr 9, 2018

Last updated

Aug 17, 2018By 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. Vincent Leroy Jones, BACHELOR'S DEGREE

Title

President

Phone

(434) 531-1008

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1366949109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2541 N GARDEN LN",
            "city": "NORTH GARDEN",
            "state": "VA",
            "postal_code": "229591604",
            "telephone_number": "434-531-1008",
            "fax_number": "434-295-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 N GARDEN LN",
            "city": "NORTH GARDEN",
            "state": "VA",
            "postal_code": "229591636",
            "telephone_number": "434-531-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE GROVE ADULT HOME. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-09",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "LEROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "434-531-1008",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BACHELOR'S DEGREE"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "VA",
            "license": "IR000055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna A. Landen, M.D
• Andrew R. Lockman, M.D.
• Celeste Pearl Delana Marsh
• Leah Neilson, LMSW
• Corrie P. Parker, FNP
• Pine Grove Group Home, LLC

• Non-emergency Medical Transport (VAN) in North Garden, VA
• Providers in North Garden, VA by specialty
• Non-emergency Medical Transport (VAN) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.