Healthcare Provider Details

I. General information

NPI: 1629236112
Provider Name (Legal Business Name): PINNACLE HEALTH FACILITIES XVI LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 02/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 S INTEROCEAN AVE
HOLYOKE CO
80734-2120
US

IV. Provider business mailing address

5420 W PLANO PKWY
PLANO TX
75093-4823
US

V. Phone/Fax

Practice location:
  • Phone: 970-854-5180
  • Fax: 970-854-5194
Mailing address:
  • Phone: 972-931-3800
  • Fax: 972-930-8191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number23R455
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number23R455
License Number StateCO

VIII. Authorized Official

Name: MRS. JAMIE LATTURE COLLIER
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 972-931-3800