Provider Demographics
NPI:1548426877
Name:PINNACLE REHABILITATION SERVICES, PLLC
Entity Type:Organization
Organization Name:PINNACLE REHABILITATION SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMOO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-910-0914
Mailing Address - Street 1:30200 TELEGRAPH RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4502
Mailing Address - Country:US
Mailing Address - Phone:248-712-1126
Mailing Address - Fax:248-792-3249
Practice Address - Street 1:30200 TELEGRAPH RD
Practice Address - Street 2:SUITE 207
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4502
Practice Address - Country:US
Practice Address - Phone:248-712-1126
Practice Address - Fax:248-792-3249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-06
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007666103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty