Provider Demographics
NPI:1780439117
Name:PINNACLE BEHAVIORAL LLC
Entity type:Organization
Organization Name:PINNACLE BEHAVIORAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FABIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OGALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-952-9768
Mailing Address - Street 1:2686 CYPRESS LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33332-3423
Mailing Address - Country:US
Mailing Address - Phone:469-952-9768
Mailing Address - Fax:
Practice Address - Street 1:2686 CYPRESS LN
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33332-3423
Practice Address - Country:US
Practice Address - Phone:469-952-9768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty