Provider Demographics
NPI:1073780185
Name:PINNACLE ABA SERVICES, INC
Entity Type:Organization
Organization Name:PINNACLE ABA SERVICES, INC
Other - Org Name:THE PINNACLE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:E
Authorized Official - Last Name:DOLL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:772-633-3205
Mailing Address - Street 1:PO BOX 1577
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33041-1577
Mailing Address - Country:US
Mailing Address - Phone:305-453-6334
Mailing Address - Fax:305-453-6374
Practice Address - Street 1:302 SOUTHARD ST STE 106
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-8404
Practice Address - Country:US
Practice Address - Phone:305-453-6334
Practice Address - Fax:305-453-6374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-00-0279251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017538400Medicaid