# PINE FORREST FARM INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pine Forrest Residential Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902020662
- **Authorized official:** MR. EMANUEL EUGENE BONAPARTE (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (828) 615-7030

## Contact information

- **Practice address:** 4190 NC HIGHWAY 801 N, MOCKSVILLE, NC 27028-6234
- **Practice address phone:** (336) 998-3480
- **Practice address fax:** (336) 998-0177
- **Mailing address:** 4190 NC HIGHWAY 801 N, MOCKSVILLE, NC 27028-6234
- **Mailing address phone:** (336) 998-3480
- **Mailing address fax:** (336) 998-0177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL030028 | NC | Yes |

## Other

- **Enumeration date:** 04/12/2007
- **Last updated:** 08/22/2020