Organization
PINE HAVEN HOME HEALTH CARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EVELYN J. RUSSELL R.N. (DIRECTOR)
(252) 523-1963
Entity
Organization
Contact information
Practice address
1108 N HERRITAGE ST, KINSTON, NC 28501-3834
(252) 523-1963
(252) 523-1123
Mailing address
1108 N HERRITAGE ST, KINSTON, NC 28501-3834
(252) 523-1963
(252) 523-1123
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC1411
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408724
—
NC
05
—
6600438
—
NC
05
—
6600841
—
NC
05
—
6600889
—
NC
Enumeration date
01/16/2007
Last updated
08/22/2020
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