Provider Demographics
NPI:1114355229
Name:PINNACLE PERSONAL CARE, LLC # EMERALD HEALTH CARE LLC SOLE MB
Entity Type:Organization
Organization Name:PINNACLE PERSONAL CARE, LLC # EMERALD HEALTH CARE LLC SOLE MB
Other - Org Name:PINNACLE PERSONAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:225-215-2273
Mailing Address - Street 1:5627 S SHERWOOD FOREST BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6032
Mailing Address - Country:US
Mailing Address - Phone:225-215-2273
Mailing Address - Fax:225-214-1232
Practice Address - Street 1:5627 S SHERWOOD FOREST BLVD STE B
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-6032
Practice Address - Country:US
Practice Address - Phone:225-215-2273
Practice Address - Fax:225-214-1232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15255253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care