Provider Demographics
NPI:1336336585
Name:PINEWOODS SAVANNAH, INC.
Entity Type:Organization
Organization Name:PINEWOODS SAVANNAH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:912-658-9952
Mailing Address - Street 1:PO BOX 16539
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-3239
Mailing Address - Country:US
Mailing Address - Phone:912-658-5592
Mailing Address - Fax:912-819-7198
Practice Address - Street 1:1900 ABERCORN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-8139
Practice Address - Country:US
Practice Address - Phone:912-658-5592
Practice Address - Fax:912-819-7198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility