Provider Demographics
NPI:1104321801
Name:PINNACLE COMMUNITY CARE SERVICES, LLC.
Entity type:Organization
Organization Name:PINNACLE COMMUNITY CARE SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:BERTELL
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:225-931-2668
Mailing Address - Street 1:2460 COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-2445
Mailing Address - Country:US
Mailing Address - Phone:225-239-5293
Mailing Address - Fax:225-239-5439
Practice Address - Street 1:2460 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-2445
Practice Address - Country:US
Practice Address - Phone:225-239-5293
Practice Address - Fax:225-239-5439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health