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Organization
PINEVIEW GROUP HOME
Active
Organization
PINEVIEW GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY BOGGS (PRESIDENT)
(417) 722-4416
Entity
Organization
Contact information
Practice address
27 HOPPER TRL, URBANA, MO 65767-9234
(417) 833-9366
(417) 722-4417
Mailing address
27 HOPPER TRL, URBANA, MO 65767-9234
(417) 722-4416
(417) 722-4417
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
—
Other
Enumeration date
03/20/2007
Last updated
08/22/2020
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