Healthcare Provider Details

I. General information

NPI: 1003207085
Provider Name (Legal Business Name): PINNACLE FAMILY HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2015
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CROSLEY ST
WEST MONROE LA
71291-2913
US

IV. Provider business mailing address

101 CROSLEY ST
WEST MONROE LA
71291-2913
US

V. Phone/Fax

Practice location:
  • Phone: 318-325-1092
  • Fax: 318-325-1222
Mailing address:
  • Phone: 318-325-1092
  • Fax: 318-325-1222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: NANCY HEAD
Title or Position: CFO
Credential:
Phone: 318-582-3587