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General NPI Number Information
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NPI Number | 1225019409
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Entity Type | Organization
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Legal Business Name | PINEVILLE REHABILITATION AND LIVING
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 02/26/2015
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Provider Practice Location Address
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Address Line | 1010 LAKEVIEW DR
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City | PINEVILLE
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State | NC
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Zip | 28134-7567
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Country | US
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Telephone | 704-889-2273
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Fax | 704-889-2010
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Provider Business Mailing Address
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Address Line | 1010 LAKEVIEW DR
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City | PINEVILLE
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State | NC
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Zip | 28134-7567
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Country | US
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Telephone | 704-889-2273
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Fax | 704-889-2010
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Authorized Official
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Title or Position | EXECUTIVE CONTROLLER
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Name | MARCELLA GRAF
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Credential |
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Telephone | 224-377-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | NH0521
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License Number State | NC
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