Provider Demographics
NPI:1063230001
Name:PINNACLE DETOX & RECOVERY, INC.
Entity type:Organization
Organization Name:PINNACLE DETOX & RECOVERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FARES
Authorized Official - Middle Name:
Authorized Official - Last Name:HAFFAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-203-3923
Mailing Address - Street 1:3890 SHADOW GROVE RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-2240
Mailing Address - Country:US
Mailing Address - Phone:626-510-6184
Mailing Address - Fax:
Practice Address - Street 1:3890 SHADOW GROVE RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-2240
Practice Address - Country:US
Practice Address - Phone:626-510-6184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility