PINEWOOD HOUSE (ASSISTED LIVING CONCEPTS INC) NPI 1003003393
Assisted Living Facility in Goose Creek, SC
About PINEWOOD HOUSE (ASSISTED LIVING CONCEPTS INC)
Pinewood House (assisted Living Concepts Inc) is a provider established in Goose Creek, South Carolina specializing in assisted living facility. The NPI number of Pinewood House (assisted Living Concepts Inc) is 1003003393 and was assigned on October 2007. The practitioner's primary taxonomy code is 310400000X with license number CRC1340 (SC). The provider is registered as an organization and their NPI record was last updated 15 years ago. The provider's is doing business as Pinewood House. The authorized official of this NPI record is Walter A Levonowich (Vice President Controller)
The CLIA number of Pinewood House is 42D0986188 registered as a "assisted living facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Pinewood House to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
| NPI | 1003003393 |
| Provider Name | PINEWOOD HOUSE (ASSISTED LIVING CONCEPTS INC) |
| Provider Location Address | 101 CENTENNIAL BLVD GOOSE CREEK, SC 29445 |
| Provider Mailing Address | W140 N8981 LILLY ROAD ATTN LEGAL DEPARTMENT MENOMONEE FALLS, WI 53051 |
| NPI Entity Type | Organization |
| Is Sole Proprietor? | N/A |
| Is Organization Subpart? | No |
| Other Organization Name | PINEWOOD HOUSE |
| Other Name Type | Doing Business As (3) |
| Enumeration Date | 10-01-2007 |
| Last Update Date | 10-01-2007 |
Primary Taxonomy
| Taxonomy Code | 310400000X |
| Classification | Assisted Living Facility |
| Type | Nursing & Custodial Care Facilities |
| License No. | CRC1340 |
| License State | SC |
| Taxonomy Description | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
Business Address
PINEWOOD HOUSE
101 CENTENNIAL BLVD
GOOSE CREEK, SC
ZIP 29445
Phone: (843) 569-2520
Fax: (843) 269-5493
Mailing Address
PINEWOOD HOUSE
W140 N8981 LILLY ROAD
ATTN LEGAL DEPARTMENT
MENOMONEE FALLS, WI
ZIP 53051
Phone: (262) 257-8888
Fax: (262) 251-7633
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003003393 is:
| CLIA Number | 42D0986188 |
| Facility Type | ASSISTED LIVING FACILITY |
| Certificate Type | Certificate of Waiver |
Other Providers at the same location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1659388387 | CHRISTY M LARSON OT Individual | Occupational Therapist | 101 CENTENNIAL BLVD GOOSE CREEK, SC 29445 (843) 569-2520 |
| 1760527923 | SANDRA M CAPRIO COTA Individual | Occupational Therapy Assistant | 101 CENTENNIAL BLVD GOOSE CREEK, SC 29445 (610) 991-2034 |
| 1851581615 | SHERYL L. DAVIS PTA Individual | Physical Therapy Assistant | 101 CENTENNIAL BLVD GOOSE CREEK, SC 29445 (843) 869-2520 |
| 1376732446 | LISA M DELK PT Individual | Physical Therapist | 101 CENTENNIAL BLVD GOOSE CREEK, SC 29445 (843) 764-0544 |
| 1740582840 | ROBIN G LA TONA OTR Individual | Occupational Therapist | 101 CENTENNIAL BLVD GOOSE CREEK, SC 29445 (843) 569-2520 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.