Organization · Type 2 NPI

Pine Grove Group Home, LLC

Intellectual and/or Developmental Disabilities Residential Treatment Facility · North Garden, VA

NPI number 1922519826 Active

Practice location

4116 Red Hill School Rd
North Garden, VA 22959-1733

Specialties and licenses

TaxonomyCodeLicense
Meals Provider 174200000XNone listed
Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary 320600000X069801001 (VA)

Intellectual and/or Developmental Disabilities Residential Treatment Facility: 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.

About NPI 1922519826

Pine Grove Group Home, LLC's National Provider Identifier is 1922519826, issued on Oct 18, 2017. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in North Garden, VA. The record was last updated on Jun 16, 2018.