Provider Demographics
NPI:1841351715
Name:PINNACLE HOME HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:PINNACLE HOME HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:OBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:IFEDIORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-422-2776
Mailing Address - Street 1:9304 FOREST LN STE 240
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6377
Mailing Address - Country:US
Mailing Address - Phone:214-503-7400
Mailing Address - Fax:214-503-7460
Practice Address - Street 1:9304 FOREST LN STE 240
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6377
Practice Address - Country:US
Practice Address - Phone:214-503-7400
Practice Address - Fax:214-503-7460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011233251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX011233OtherHOME HEATH CARE LICENSE
TX011233OtherHOME HEATH CARE LICENSE