MEDICARE: PINNACLE RECOVERY CENTERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1407656465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE RECOVERY CENTERS

Provider Business Mailing Address
First Line	:	7460 DARBY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-3235
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1045 BIG DANGER RD
Second Line	:
City	:	CLARKSVILLE
State	:	AR
Zip	:	72830-9457
Country	:	US
Telephone Number	:	501-732-9505
Fax Number	:

Authorized Official
Title or Position	:	BILLING DIRECTOR
Name	:	THI HOANG
Credential	:
Telephone Number	:	702-205-8232

Provider Enumeration Date	:	03/18/2025
Last Update Date	:	03/18/2025

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