NPI 1053072470

Pine Grove Opco LLC

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Elgin, SC

Practice location

Address: 1500 Chestnut Rd, Elgin, SC 29045-9022
Phone: (803) 438-3011
Mailing address: PO Box 100, Elgin, SC 29045-0100

Authorised official

Name: Doris Singleton
Title: Executive Director
Phone: (803) 438-3011

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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Registry record

NPI: 1053072470
Entity type: Organization
NPI issued: 7 Jan 2022
Record last updated: 7 Jan 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.