Provider Demographics
NPI:1841245164
Name:PINNACLE HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:PINNACLE HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ADETOKUNBO
Authorized Official - Middle Name:ABOSEDE
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:214-340-4000
Mailing Address - Street 1:910 FALCON TRL
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-3836
Mailing Address - Country:US
Mailing Address - Phone:214-340-4000
Mailing Address - Fax:214-340-4097
Practice Address - Street 1:910 FALCON TRL
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-3836
Practice Address - Country:US
Practice Address - Phone:214-340-4000
Practice Address - Fax:214-340-4097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008297251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001012187Medicaid
TX001012187Medicaid