Provider Demographics
NPI:1376874586
Name:PINEVIEW NURSING AND REHABILITATION CENTER, LLC
Entity Type:Organization
Organization Name:PINEVIEW NURSING AND REHABILITATION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PINTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-535-3795
Mailing Address - Street 1:184 NEW EGYPT RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2932
Mailing Address - Country:US
Mailing Address - Phone:718-535-3795
Mailing Address - Fax:718-338-1019
Practice Address - Street 1:1150 LOOP 304 EAST
Practice Address - Street 2:
Practice Address - City:CROCKETT
Practice Address - State:TX
Practice Address - Zip Code:75835-0000
Practice Address - Country:US
Practice Address - Phone:936-544-2051
Practice Address - Fax:936-544-7669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX128429314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001014745Medicaid
TX001014745Medicaid