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Country Pines Inc

Country Pines Inc is a health care provider in Lagrange, NC. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 2308 Oakdale Rd, La Grange, NC 28551-8627, US
Practice Location Phone252-747-4868
Practice Location Fax
Legal Business NameCOUNTRY PINES INC
Other Organization NameCOUNTRY PINES GC
Other Organization Name TypeAn Other Name
NPI ?1467672535
Entity TypeOrganization
Enumeration Date ? Apr 30, 2007
Last Update Date ? Jul 8, 2007
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Country Pines Inc

SpecialtySpecializationLicenseLicense State
Community Based Residential Treatment Facility, Mental Illness MHL040014North Carolina

legacy-id-icon Legacy Provider IDs of Country Pines Inc

Provider IdIssuer StateIssuer TypeIssuer
7804005North CarolinaMedicaid

official-icon Authorized Official of Country Pines Inc

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Country Pines Inc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Mr. Kenneth Michael Sauls (BS BUSINESS)
Authorized Official Title/PositionVICE PRESIDENT
Authorized Official Phone Number919-778-4009