Provider Demographics
NPI:1558875575
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:MR
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:352-666-0922
Practice Address - Street 1:2090 PALM BEACH LAKES BLVD STE 402
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6512
Practice Address - Country:US
Practice Address - Phone:727-534-7526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-29
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA299993944251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health