| NPI | 1184077364 |
|---|---|
| Other Name | PINE VALE INC. |
| Entity Type | Organization |
| Authorized Contact | SHEILA BEATY Counselor 662-286-6555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2016-07-22 |