Healthcare Provider Details

I. General information

NPI: 1457365975
Provider Name (Legal Business Name): PINELEAF INVESTMENTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 EIGHTH STREET
HELENA GA
31037
US

IV. Provider business mailing address

PO BOX 314
HELENA GA
31037-0314
US

V. Phone/Fax

Practice location:
  • Phone: 229-868-7406
  • Fax:
Mailing address:
  • Phone: 229-868-7406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: BUFORD T COOK
Title or Position: PRESIDENT
Credential:
Phone: 229-868-7406