Organization · Type 2 NPI

Pinewood Estates Assisted Living Facility

Assisted Living Facility · Melbourne, FL

NPI number 1174992622 Active

Practice location

4055 Pinewood Rd
Melbourne, FL 32934-9053

Call (786) 376-4043 Map

Mailing address

PO Box 640902
Miami, FL 33164-0902

Specialties and licenses

Taxonomy	Code	License
Assisted Living Facility Primary	310400000X	AL12678 (FL)
Assisted Living Facility (Mental Illness)	3104A0625X	AL12678 (FL)
Alzheimer Center (Dementia Center)	311500000X	AL12678 (FL)
Respite Care	385H00000X	AL12678 (FL)

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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NPI record

NPI: 1174992622
Entity type: Organization (Type 2)
Issued: Sep 15, 2015
Last updated: Sep 15, 2015
Status: Active
Subpart: Yes of Pinewood Estates Assisted Living Facility

Other names

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Pinewood Estates Assisted Living Community · doing business as

Authorized official

Mr. Peter D. Fellows
Director
(786) 376-4043

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1174992622

Pinewood Estates Assisted Living Facility's National Provider Identifier is 1174992622, issued on Sep 15, 2015. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Melbourne, FL. The record was last updated on Sep 15, 2015.