Provider Demographics
NPI:1700245990
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:
Authorized Official - Last Name:IKE
Authorized Official - Suffix:
Authorized Official - Credentials:
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:
Mailing Address - Fax:
Practice Address - Street 1:234 SEVEN OAKS RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-1125
Practice Address - Country:US
Practice Address - Phone:910-728-6019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-032-143311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home