Pinnacle Homes, Dda, LLC
Organization Active NPI Mental Illness Community Based Residential Treatment Facility · Pinnacle, NC
NPI 1205913019 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1205913019
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Illness Community Based Residential Treatment Facility 320800000X
- License
- MHL085028 (NC)
- Legal business name
- PINNACLE HOMES, DDA, LLC
- Practice address
- 1169 Perch Rd
Pinnacle, NC 27043-8312 - Phone
- (336) 368-2778
- Fax
- (336) 368-2779
- NPI assigned
- Nov 1, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Earl R. Forest
- Title
- Administrator
- Phone
- (336) 368-2778
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Pinnacle Homes Dda LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | MHL085028 | NC | Yes |
Addresses
Primary practice location
1169 Perch Rd
Pinnacle, NC 27043-8312
Mailing address
PO Box 70
Pinnacle, NC 27043-0070
Phone (336) 368-2778
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7804284 | Medicaid | NC |
Other providers in Pinnacle, NC
- Leigh A Meeks
- Judi Hani Merritt
- Amy C Pace
- Pinnacle Homes Dda LLC
- Pinnacle Homes Dda LLC
- April Amos Robertson
- Thomas John Shutsky
- Theraplay of North Carolina, PC
All providers in Pinnacle, NC · Mental Illness Community Based Residential Treatment Facility in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.