Pine Grove Opco LLC
NPI #1053072470 in Elgin, South Carolina
Provider Information
- NPI Number
- 1053072470
- Entity Type
- Organization
- Organization Name
- Pine Grove Opco LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- PINE GROVE OPCO LLC
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Jan 7, 2022
- Last Updated
- Jan 7, 2022
Practice Location
- Address
- 1500 CHESTNUT RD
- City
- Elgin
- State
- South Carolina
- ZIP Code
- 29045-9022
- Phone
- (803) 438-3011
Authorized Official
- Name
- DORIS SINGLETON
- Title
- EXECUTIVE DIRECTOR
- Phone
- (803) 438-3011
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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