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Organization
PINE VALE INC
Active
Organization
PINE VALE INC
Active
Other names
Pine Vale Childrens Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS BARAGONA (DIRECTOR)
(662) 286-6555
Entity
Organization
Contact information
Practice address
1872 COUNTY ROAD 700, CORINTH, MS 38834-8734
(662) 286-6555
(662) 287-0283
Mailing address
1872 COUNTY ROAD 700, CORINTH, MS 38834-8734
(662) 286-6555
(662) 287-0283
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
06/24/2011
Last updated
06/24/2011
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