Healthcare Provider Details
I. General information
NPI: 1154254001
Provider Name (Legal Business Name): PINE VIEW NURSING OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
411 PINE ST
SYLVANIA GA
30467-2035
US
IV. Provider business mailing address
411 PINE ST
SYLVANIA GA
30467-2035
US
V. Phone/Fax
- Phone: 912-564-2015
- Fax:
- Phone: 912-564-2015
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MEIR
LANDAU
Title or Position: MEMBER OF LLC
Credential:
Phone: 912-564-2015