Healthcare Provider Details

I. General information

NPI: 1720060544
Provider Name (Legal Business Name): PINNACLE HEALTH FACILITIES OF LOUISIANA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 07/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 JUSTA ST
MORGAN CITY LA
70380-1513
US

IV. Provider business mailing address

5420 W PLANO PKWY
PLANO TX
75093-4823
US

V. Phone/Fax

Practice location:
  • Phone: 985-384-1726
  • Fax: 985-384-4942
Mailing address:
  • Phone: 972-931-3800
  • Fax: 972-767-6222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number719
License Number StateLA

VIII. Authorized Official

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