| NPI | 1518663053 |
|---|---|
| Doing Business As | PINETREE LANE |
| Entity Type | Organization |
| Authorized Contact | DARIAN S WEST CEO 210-403-9372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2023-07-10 |