Organization
PINE GROVE ADULT HOME. INC
Active
Organization
PINE GROVE ADULT HOME. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VINCENT LEROY JONES BACHELOR'S DEGREE (PRESIDENT)
(434) 531-1008
Entity
Organization
Contact information
Practice address
2609 N GARDEN LN, NORTH GARDEN, VA 22959-1636
(434) 531-1008
Mailing address
2541 N GARDEN LN, NORTH GARDEN, VA 22959-1604
(434) 531-1008
(434) 295-1185
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
IR000055
VA
Other
Enumeration date
04/09/2018
Last updated
08/17/2018
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