Provider Demographics
NPI:1285191825
Name:PINNACLE HOME CARE OF THE PALM BEACHES, LLC.
Entity Type:Organization
Organization Name:PINNACLE HOME CARE OF THE PALM BEACHES, LLC.
Other - Org Name:PINNACLE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:DONALDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-534-7526
Mailing Address - Street 1:4023 TAMPA RD STE 2200
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3212
Mailing Address - Country:US
Mailing Address - Phone:727-534-7526
Mailing Address - Fax:
Practice Address - Street 1:312 S OLD DIXIE HWY STE 101
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7489
Practice Address - Country:US
Practice Address - Phone:727-534-7526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PINNACLE HOME CARE OF THE PALM BEACHES, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-01
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health