# PINE GROVE OPCO LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PINE GROVE OPCO LLC
- **Other names:** Pine Grove
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1053072470
- **Legal business name:** PINE GROVE OPCO LLC
- **Authorized official:** DORIS SINGLETON (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (803) 438-3011

## Contact information

- **Practice address:** 1500 CHESTNUT RD, ELGIN, SC 29045-9022
- **Practice address phone:** (803) 438-3011
- **Mailing address:** PO BOX 100, ELGIN, SC 29045-0100
- **Mailing address phone:** (803) 438-3011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 01/07/2022
- **Last updated:** 01/07/2022