Provider Demographics
NPI:1457365975
Name:PINELEAF INVESTMENTS, INC.
Entity Type:Organization
Organization Name:PINELEAF INVESTMENTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BUFORD
Authorized Official - Middle Name:T
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-868-7406
Mailing Address - Street 1:PO BOX 314
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:GA
Mailing Address - Zip Code:31037-0314
Mailing Address - Country:US
Mailing Address - Phone:229-868-7406
Mailing Address - Fax:
Practice Address - Street 1:503 EIGHTH STREET
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:GA
Practice Address - Zip Code:31037
Practice Address - Country:US
Practice Address - Phone:229-868-7406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1035Medicaid
GA1035Medicaid