Organization
PINECREST LLC
Active
Other names
Pinecrest Guest Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE RON GUINS (MEMBER/MANAGER)
(318) 686-0040
Entity
Organization
Contact information
Practice address
133 PINE ST, HAZLEHURST, MS 39083-2309
(601) 894-1411
(601) 894-3282
Mailing address
133 PINE ST, HAZLEHURST, MS 39083-2309
(601) 894-1411
(601) 894-3282
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
366
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00230140
—
MS
Enumeration date
09/29/2005
Last updated
08/22/2020
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