| NPI | 1649824913 |
|---|---|
| Doing Business As | PINE VALLEY ASSISTED LIVING |
| Entity Type | Organization |
| Authorized Contact | THOMAS A. ONGWELA Adminstrator 269-598-5595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2019-07-25 |