Healthcare Provider Details

I. General information

NPI: 1376874586
Provider Name (Legal Business Name): PINEVIEW NURSING AND REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2010
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 LOOP 304 EAST
CROCKETT TX
75835-0000
US

IV. Provider business mailing address

184 NEW EGYPT RD
LAKEWOOD NJ
08701-2932
US

V. Phone/Fax

Practice location:
  • Phone: 936-544-2051
  • Fax: 936-544-7669
Mailing address:
  • Phone: 718-535-3795
  • Fax: 718-338-1019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number128429
License Number StateTX

VIII. Authorized Official

Name: ESTHER PINTER
Title or Position: MEMBER
Credential:
Phone: 718-535-3795