Organization · Type 2 NPI
Pine Grove Group Home, LLC
Intellectual and/or Developmental Disabilities Residential Treatment Facility · North Garden, VA
Practice location
4116 Red Hill School Rd
North Garden, VA 22959-1733
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Meals Provider | 174200000X | None listed |
| Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary | 320600000X | 069801001 (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.