Pine Grove Adult Home& Care, Inc

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

ALF1078422 Issued in VA

Legal business name

PINE GROVE ADULT HOME& CARE, INC

Practice address

2609 North Garden Lane
Noth Garden, VA 22959

Phone

(434) 295-4408

Fax

(434) 295-1185

NPI assigned

Oct 7, 2014

Last updated

Oct 7, 2014By 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

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": "1412640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412640000000",
    "number": "1740683671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 NORTH GARDEN LANE",
            "city": "NOTH GARDEN",
            "state": "VA",
            "postal_code": "22959",
            "telephone_number": "434-295-4408",
            "fax_number": "434-295-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 NORTH GARDEN LANE",
            "city": "NOTH GARDEN",
            "state": "VA",
            "postal_code": "22959",
            "telephone_number": "434-295-4408",
            "fax_number": "434-295-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE GROVE ADULT HOME& CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-07",
        "last_updated": "2014-10-07",
        "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."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "VA",
            "license": "ALF1078422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.