Pine Grove Inc.

LBN: Pine Grove Inc.
Pine Grove Inc. is an health care organization with primary practice located at 1500 Chestnut Road , Elgin SC 29045-0100. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, which is considered as the primary health care specialty. Pine Grove Inc. can be contacted via phone (803) 438-3011, or through Moen, James D. via phone (803) 438-3011.

Contact Information

Primary practice address
1500 Chestnut Road Elgin SC 29045-0100
Phone: (803) 438-3011
Fax: (803) 438-8611
Website:
Map and Directions
Authorized official contact:
Name: Moen, James D.
Phone: (803) 438-3011

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X SR0008132001CCI South Carolina

Profile Details

NPI number 1346307899
LBN Legal business name Pine Grove Inc.
DBA Doing business as
Authorized official Moen, James D.
Entity Organization
Organization subpart 1 No
Enumeration date Jan 3rd, 2007
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346307899 NPPES
South Carolina MEDICAID 961MXH

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