Provider Demographics
NPI:1083081616
Name:PINNACLE TREATMENT CENTERS PA-VI, LLC
Entity Type:Organization
Organization Name:PINNACLE TREATMENT CENTERS PA-VI, LLC
Other - Org Name:GREENFIELD COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR OF CONTRACT MGMT
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:
Authorized Official - Last Name:TANIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-533-8762
Mailing Address - Street 1:1317 ROUTE 73 STE 200
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-2202
Mailing Address - Country:US
Mailing Address - Phone:856-439-6111
Mailing Address - Fax:
Practice Address - Street 1:11127 PERRY HWY
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-6557
Practice Address - Country:US
Practice Address - Phone:814-337-7431
Practice Address - Fax:814-332-0917
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PINNACLE TREATMENT CENTERS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-31
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone