NPIMap

Organization Active NPI

Pine Haven Home Health Care Services Inc

  • Personal Care Attendant
  • Kinston, NC
National Provider Identifier
1851565295
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Legal business name
PINE HAVEN HOME HEALTH CARE SERVICES INC
Practice address
1108 N Herritage St
Kinston, NC 28501-3834
Phone
(252) 523-1963
Fax
(252) 523-1123
NPI assigned
Apr 16, 2008
Last updated
Apr 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Authorized official

Name
L. Bernard Russell
Title
Manager
Phone
(252) 523-1963

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X NU Primary

Addresses

Primary practice location

1108 N Herritage St
Kinston, NC 28501-3834

Mailing address

1108 N Herritage St
Kinston, NC 28501-3834
Phone (252) 523-1963

Other identifiers 1

IdentifierTypeStateIssuer
3408724MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Pine Haven Home Health Care Services Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1851565295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 N HERRITAGE ST",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285013834",
            "telephone_number": "252-523-1963",
            "fax_number": "252-523-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 N HERRITAGE ST",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285013834",
            "telephone_number": "252-523-1963",
            "fax_number": "252-523-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE HAVEN HOME HEALTH CARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-16",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "L.",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "252-523-1963"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408724",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kinston, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; 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.