# PINES VILLAGE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104992528
- **Authorized official:** BRENDEN GAROZZO (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (732) 849-0400

## Contact information

- **Practice address:** 509 ROUTE 530, WHITING, NJ 08759-3145
- **Practice address phone:** (732) 849-0400
- **Practice address fax:** (732) 350-0540
- **Mailing address:** 509 ROUTE 530, WHITING, NJ 08759-3145
- **Mailing address phone:** (732) 849-0400
- **Mailing address fax:** (732) 350-0540

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 65A001 | NJ | — |
| 314000000X | Skilled Nursing Facility | 656000 | NJ | Yes |
| 314000000X | Skilled Nursing Facility | — | — | — |

## Other

- **Enumeration date:** 11/28/2006
- **Last updated:** 09/01/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7225008 | — | NJ |
| 01 | — | 7225016 | MEDICAID ASSISTED | NJ |