Provider Demographics
NPI:1801239959
Name:PINNACLE HEALTH SERVICES,LLC
Entity type:Organization
Organization Name:PINNACLE HEALTH SERVICES,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-256-0065
Mailing Address - Street 1:6025 STAGE RD
Mailing Address - Street 2:42-372
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-8374
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6025 STAGE RD
Practice Address - Street 2:42-372
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-8374
Practice Address - Country:US
Practice Address - Phone:866-256-0065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services