Healthcare Provider Details

I. General information

NPI: 1437524733
Provider Name (Legal Business Name): PINNACLE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2015
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4131 N 24TH ST STE C203
PHOENIX AZ
85016-6256
US

IV. Provider business mailing address

4131 N 24TH ST STE C203
PHOENIX AZ
85016-6256
US

V. Phone/Fax

Practice location:
  • Phone: 602-334-1353
  • Fax:
Mailing address:
  • Phone: 602-334-1353
  • Fax: 602-296-5337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number4540
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: MORGAN HAIR
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 602-334-1353