Provider Demographics
NPI:1508346859
Name:PINNACLE COMMUNITY CARE
Entity Type:Organization
Organization Name:PINNACLE COMMUNITY CARE
Other - Org Name:PINNACLE COMMUNITY CARE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAXTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-397-7907
Mailing Address - Street 1:2211 CHESTERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-2800
Mailing Address - Country:US
Mailing Address - Phone:804-397-7907
Mailing Address - Fax:
Practice Address - Street 1:2211 CHESTERMAN AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-2800
Practice Address - Country:US
Practice Address - Phone:804-397-7907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA301903001101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty