Pine Crest Village LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

10344 Issued in WI

Legal business name

PINE CREST VILLAGE LLC

Practice address

1241 N 18TH Ave
Sturgeon Bay, WI 54235-3535

Phone

(920) 746-1280

Fax

(920) 746-9404

NPI assigned

Aug 7, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Amber A May

Title

Facility Manager

Phone

(920) 746-1280

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1851582597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 N 18TH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542353535",
            "telephone_number": "920-746-1280",
            "fax_number": "920-746-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 N 18TH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542353535",
            "telephone_number": "920-746-1280",
            "fax_number": "920-746-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE CREST VILLAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "MAY",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "FACILITY MANAGER",
        "authorized_official_telephone_number": "920-746-1280",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WI",
            "license": "10344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peninsula Chiropractic Center Inc.
• Peninsula Podiatry LLC
• Peninsula Vision Care LLC
• Sherry J Pesch
• Mollie Pfeifer Petersen, PAC
• Michael F Pinelli, CSAC
• Ronald Pluszczynski, M.D.
• Crystal Szucs Pomeroy, PHYSICAL THERAPIST
• Ryan Popelka
• Courtney Prusak, NP

• Assisted Living Facility in Sturgeon Bay, WI
• Providers in Sturgeon Bay, WI by specialty
• Assisted Living Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; 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.