# PINE HILLS HEALTH CENTER, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1598011710
- **Authorized official:** MR. CHARLES G GLADNEY (MANAGING MEMBER)
- **Authorized official phone:** (318) 281-0078

## Contact information

- **Practice address:** 144 FM 1252 W, KILGORE, TX 75662-5093
- **Practice address phone:** (903) 984-5688
- **Practice address fax:** (903) 984-8010
- **Mailing address:** 1523 TEXAS AVE, BASTROP, LA 71220-4043
- **Mailing address phone:** (318) 281-0078
- **Mailing address fax:** (318) 281-2753

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 07/25/2012
- **Last updated:** 07/25/2012