Provider Demographics
NPI:1427601327
Name:PINNACLE ASSISTED LIVING
Entity Type:Organization
Organization Name:PINNACLE ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL OPERATIONS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:FAY
Authorized Official - Middle Name:
Authorized Official - Last Name:JAGO
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:865-250-4078
Mailing Address - Street 1:10520 WATERVILLE LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-3754
Mailing Address - Country:US
Mailing Address - Phone:865-444-1451
Mailing Address - Fax:865-337-5454
Practice Address - Street 1:10520 WATERVILLE LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-3754
Practice Address - Country:US
Practice Address - Phone:865-444-1451
Practice Address - Fax:865-337-5454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility