NPI 1225324510

Pine Vale INC

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Corinth, MS

Practice location

Address: 1872 County Road 700, Corinth, MS 38834-8734
Phone: (662) 286-6555
Fax: (662) 287-0283

Authorised official

Name: Thomas Baragona
Title: Director
Phone: (662) 286-6555

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X

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Registry record

NPI: 1225324510
Entity type: Organization
NPI issued: 24 Jun 2011
Record last updated: 24 Jun 2011

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.