Provider Demographics
NPI:1336538156
Name:PINNACLE HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:PINNACLE HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OBBY
Authorized Official - Middle Name:A
Authorized Official - Last Name:IKE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:910-728-6019
Mailing Address - Street 1:183 PEATMOSS DR
Mailing Address - Street 2:APT L
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-8970
Mailing Address - Country:US
Mailing Address - Phone:910-728-6019
Mailing Address - Fax:919-872-7450
Practice Address - Street 1:183 PEATMOSS DR
Practice Address - Street 2:APT L
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-8970
Practice Address - Country:US
Practice Address - Phone:910-728-6019
Practice Address - Fax:919-872-7450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-16
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2523253Z00000X
NCFCL032143311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No253Z00000XAgenciesIn Home Supportive Care