Provider Demographics
NPI:1760922645
Name:PINNACLE TREATMENT CENTERS KY-1, LLC D/B/A RECOVERY WORKS GREENUP
Entity Type:Organization
Organization Name:PINNACLE TREATMENT CENTERS KY-1, LLC D/B/A RECOVERY WORKS GREENUP
Other - Org Name:RECOVERY WORKS GREENUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR OF CONTRACT MANA
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:
Authorized Official - Last Name:TANIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-533-8762
Mailing Address - Street 1:4634 STATE ROUTE 1043
Mailing Address - Street 2:
Mailing Address - City:SOUTH SHORE
Mailing Address - State:KY
Mailing Address - Zip Code:41175-7661
Mailing Address - Country:US
Mailing Address - Phone:606-498-4174
Mailing Address - Fax:
Practice Address - Street 1:4634 STATE ROUTE 1043
Practice Address - Street 2:
Practice Address - City:SOUTH SHORE
Practice Address - State:KY
Practice Address - Zip Code:41175-7661
Practice Address - Country:US
Practice Address - Phone:606-498-4174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Single Specialty