(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Intermediate Care Facility, Mentally Retarded | 315P00000X |
* Indicates primary specialty
| NPI Number | 1811192271 |
| Legal business name LBN |
PINE RIDGE RESIDENCE INC |
| Authorized official | DONALD BLOOFLAT - (ADMINISTRATOR) |
| Entity | Organization |
| Organization subpart | No |
| Enumeration date | 06/18/2007 |
| Last updated | 08/22/2020 - About 6 years ago |
| Sole proprietor1 | Not specified |
| Identifiers | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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