Provider Demographics
NPI:1063716199
Name:PINNACLE ALLIANCE HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:PINNACLE ALLIANCE HOME HEALTH CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-652-2651
Mailing Address - Street 1:9889 GATE PKWY N
Mailing Address - Street 2:UNIT 301
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-9228
Mailing Address - Country:US
Mailing Address - Phone:904-652-2651
Mailing Address - Fax:904-652-2653
Practice Address - Street 1:9889 GATE PKWY N
Practice Address - Street 2:UNIT 301
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-9228
Practice Address - Country:US
Practice Address - Phone:904-652-2651
Practice Address - Fax:904-652-2653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
APPLIED FOR251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health