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General NPI Number Information
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NPI Number | 1063308872
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Entity Type | Organization
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Legal Business Name | PINE NEEDLE OF GREENVILLE
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 600 GLENDALE AVE
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City | GREENVILLE
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State | AL
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Zip | 36037-1325
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Country | US
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Telephone | 334-382-3757
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Fax |
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Provider Business Mailing Address
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Address Line | 3590B PELHAM PKWY STE 219
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City | PELHAM
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State | AL
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Zip | 35124-2034
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Country | US
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Telephone | 205-586-0056
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARY PERKINS
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Credential |
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Telephone | 334-293-1141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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