Organization
PINE GROVE ADULT HOME& CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VINCENT LEROY JONES (PRESIDENT)
(434) 531-1008
Entity
Organization
Contact information
Practice address
2609 NORTH GARDEN LANE, NOTH GARDEN, VA 22959
(434) 295-4408
(434) 295-1185
Mailing address
2609 NORTH GARDEN LANE, NOTH GARDEN, VA 22959
(434) 295-4408
(434) 295-1185
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
ALF1078422
VA
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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