Healthcare Provider Details

I. General information

NPI: 1114355229
Provider Name (Legal Business Name): PINNACLE PERSONAL CARE, LLC # EMERALD HEALTH CARE LLC SOLE MB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2013
Last Update Date: 10/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5627 S SHERWOOD FOREST BLVD STE B
BATON ROUGE LA
70816-6032
US

IV. Provider business mailing address

5627 S SHERWOOD FOREST BLVD STE B
BATON ROUGE LA
70816-6032
US

V. Phone/Fax

Practice location:
  • Phone: 225-215-2273
  • Fax: 225-214-1232
Mailing address:
  • Phone: 225-215-2273
  • Fax: 225-214-1232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number15255
License Number StateLA

VIII. Authorized Official

Name: MRS. COLLEEN RYAN THOMAS
Title or Position: EXECUTIVE DIRECTOR
Credential: R.N., B.S.N.
Phone: 225-215-2273