Organization
PINEHOUSE, INC.
Active
Other names
OakRidge Assisted Living Facility
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYMON W. THOMAS (PRESIDENT)
(386) 294-5050
Entity
Organization
Contact information
Practice address
297 SW COUNTY ROAD 300, MAYO, FL 32066-4402
(386) 294-5050
(386) 294-5057
Mailing address
297 SW COUNTY ROAD 300, MAYO, FL 32066-4402
(386) 294-5050
(386) 294-5057
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL9863
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140629900
—
FL
05
—
678902100
—
FL
Enumeration date
02/15/2006
Last updated
05/19/2011
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