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Organization
PINE HAVENHOME HEALTH CARE SERVICES INC.
Active
Organization
PINE HAVENHOME HEALTH CARE SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEE BERNARD RUSSELL (MANAGER)
(252) 523-1963
Entity
Organization
Contact information
Practice address
1108 N HERRITAGE ST, KINSTON, NC 28501-3834
(252) 523-1963
Mailing address
1108 N HERRITAGE ST, KINSTON, NC 28501-3834
(252) 523-1963
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6600841
—
NC
Enumeration date
03/14/2008
Last updated
03/14/2008
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