Organization
SH1 PELHAM OPCO LLC
Active
Other names
Pine Grove Senior Living
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI BAKER (FINANCE AND LICENSING COORDINATOR)
(564) 203-3620
Entity
Organization
Contact information
Practice address
2006 PELHAM RD, GREENVILLE, SC 29615-4005
(864) 288-3331
(864) 286-9582
Mailing address
5101 NE 82ND AVE STE 200, VANCOUVER, WA 98662-6343
(360) 254-9442
(360) 254-1770
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/16/2024
Last updated
08/16/2024
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