Organization
1304 WALNUT STREET OPERATIONS, LLC
Active
Other names
Pine View Health and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
TIM LEHNER (MANAGER)
(770) 698-9040
Entity
Organization
Contact information
Practice address
1304 WALNUT ST, WAYNESBORO, MS 39367-2232
(601) 735-9025
(601) 735-2865
Mailing address
1304 WALNUT ST, WAYNESBORO, MS 39367-2232
(601) 735-9025
(601) 735-2865
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000230118
—
MS
Enumeration date
03/04/2022
Last updated
09/13/2024
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