Provider Demographics
NPI:1710259437
Name:BHC PINNACLE POINTE HOSPITAL, INC.
Entity Type:Organization
Organization Name:BHC PINNACLE POINTE HOSPITAL, INC.
Other - Org Name:THE POINTE OUTPATIENT BEHAVIORAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-223-3322
Mailing Address - Street 1:910 N EAST ST
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-3327
Mailing Address - Country:US
Mailing Address - Phone:501-381-2991
Mailing Address - Fax:501-381-2005
Practice Address - Street 1:910 N EAST ST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-3327
Practice Address - Country:US
Practice Address - Phone:501-381-2001
Practice Address - Fax:501-381-2005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-27
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR190131526Medicaid