Provider Demographics
NPI:1649002882
Name:THE PINES OF CAMDEN LLC
Entity type:Organization
Organization Name:THE PINES OF CAMDEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SALLEE
Authorized Official - Middle Name:SASSER
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-303-3937
Mailing Address - Street 1:550 PONDEROSA DR
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:AL
Mailing Address - Zip Code:36726-2313
Mailing Address - Country:US
Mailing Address - Phone:334-682-4231
Mailing Address - Fax:334-682-5224
Practice Address - Street 1:550 PONDEROSA DR
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AL
Practice Address - Zip Code:36726-2313
Practice Address - Country:US
Practice Address - Phone:334-682-4231
Practice Address - Fax:334-682-5224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-16
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility