| NPI | 1225324510 |
|---|---|
| Doing Business As | PINE VALE CHILDRENS HOME |
| Entity Type | Organization |
| Authorized Contact | THOMAS BARAGONA Director 662-286-6555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2011-06-24 |