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PINE LEAF PERSONAL CARE HOME NPI 1235697483


NPI Information

NPI: 1235697483
Provider Name: PINE LEAF PERSONAL CARE HOME
Classification: Nursing Care - 251J00000X
Entity Type: Organization
Address:
121 S ELM ST
EAST DUBLIN, GA
ZIP 31027
Phone: (478) 575-0083
Get Directions

PINE LEAF PERSONAL CARE HOME is a nursing care in East Dublin, GA. The provider is a Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services. PINE LEAF PERSONAL CARE HOME NPI is 1235697483. The provider is registered as an organization entity type.

The provider's business location address is:

121 S ELM ST
EAST DUBLIN, GA
ZIP 31027-778
Phone: (478) 575-0083

The provider's authorized official is Shomankia Pinkston Mills .
The authorized official title is Director and has the following contact phone number (478) 575-0083.

The enumeration date for this NPI number is 3/6/2019 and was last updated on 3/6/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251E00000XHome HealthNo
2251J00000XNursing CareYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13155885MEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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