| Pinnacle Community Care Services, Llc. | |
|
2460 College Dr Baton Rouge LA 70808-2445 | |
| (225) 239-5293 | |
| (225) 239-5439 |
| Full Name | Pinnacle Community Care Services, Llc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2460 College Dr, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Joseph Bertell Davis (PROGRAM DIRECTOR) |
| Authorized Official Contact | 2259312668 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pinnacle Community Care Services, Llc. 2460 College Dr Baton Rouge LA 70808-2445 Ph: (225) 239-5293 | Pinnacle Community Care Services, Llc. 2460 College Dr Baton Rouge LA 70808-2445 Ph: (225) 239-5293 |
| NPI Number | 1104321801 |
|---|---|
| Provider Enumeration Date | 03/26/2018 |
| Last Update Date | 03/26/2018 |
| Medicare PECOS PAC ID | 7719237544 |
|---|---|
| Medicare Enrollment ID | O20180829000723 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104321801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Louisiana) | Primary |
| Provider Name | Khrishandalyn Rationne Hicks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821464546 PECOS PAC ID: 7810238763 Enrollment ID: I20190403001093 |
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