NPIMap

Organization Active NPI

Pinnacle House Psychosocial Rehabilitation Program

  • Community/Behavioral Health Agency
  • Little Rock, AR
National Provider Identifier
1386880961
Registry record updated Jan 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PINNACLE HOUSE PSYCHOSOCIAL REHABILITATION PROGRAM
Practice address
1020 West Daisy L Gatson Bates Drive
Little Rock, AR 72202
Phone
(501) 371-9058
Fax
(501) 686-9618
NPI assigned
Jan 2, 2009
Last updated
Jan 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tom Grunden
Title
Executive Director
Phone
(501) 686-9300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1020 West Daisy L Gatson Bates Drive
Little Rock, AR 72202

Mailing address

4400 Shuffield Dr
Little Rock, AR 72205
Phone (501) 686-9300

Other identifiers 1

IdentifierTypeStateIssuer
137440726MedicaidAR

National Provider Directory

National Provider Directory
Tax ID family
Fullerton Treatment Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1230854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230854400000",
    "number": "1386880961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 SHUFFIELD DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72205",
            "telephone_number": "501-686-9300",
            "fax_number": "501-686-9618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 WEST DAISY L GATSON BATES DRIVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72202",
            "telephone_number": "501-371-9058",
            "fax_number": "501-686-9618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE HOUSE PSYCHOSOCIAL REHABILITATION PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-02",
        "last_updated": "2009-01-02",
        "status": "A",
        "authorized_official_last_name": "GRUNDEN",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "501-686-9300"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137440726",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.