Provider Demographics
NPI:1194085498
Name:PINNACLE HOME HEALTHCARE AGENCY, LLC
Entity type:Organization
Organization Name:PINNACLE HOME HEALTHCARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:OKORIE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:480-703-5429
Mailing Address - Street 1:9145 E HACKAMORE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-2205
Mailing Address - Country:US
Mailing Address - Phone:480-703-5429
Mailing Address - Fax:
Practice Address - Street 1:7900 E GREENWAY RD STE 209
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1715
Practice Address - Country:US
Practice Address - Phone:480-703-5429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZL17600374251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health