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Pine Grove Group Home, Llc
Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Garden, Virginia
NPI 1922519826

Pine Grove Group Home, Llc is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in North Garden, VA. Pine Grove Group Home, Llc practices in North Garden, VA. The NPI Number for Pine Grove Group Home, Llc is 1922519826 and holds a License No. (Virginia).

The current practice location address for Pine Grove Group Home, Llc is 4116 Red Hill School Rd, North Garden, VA and can be reached out via phone at 434-295-1615.

Location: 4116 Red Hill School Rd, North Garden, VA, 22959-1733
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1922519826
Provider Name
Pine Grove Group Home, Llc
Credential
Provider Entity Type
Organization
Address
4116 Red Hill School Rd, North Garden, VA, 22959-1733
Phone Number
434-295-1615
Fax Number
Provider Enumeration Date
10/18/2017
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0269801001 01 VA PROVIDER
0269801001 01 PROVIDER
institution
Provider Business Practice Location Address Details
Address
4116 Red Hill School Rd
City
North Garden
State
Virginia
Zip
22959-1733
Phone Number
434-295-1615
Fax Number
person
Provider Business Mailing Address Details
Address
4116 Red Hill School Rd
City
North Garden
State
Virginia
Zip
22959-1733
Phone Number
434-295-1615
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Meals
Speciality
-
Taxonomy
174200000X
License No.
069801001 (Virginia)
Definition
A public or privately owned facility providing meals to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
()
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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