Healthcare Provider Details

I. General information

NPI: 1083257638
Provider Name (Legal Business Name): PINNACLE CARE RESOURCES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2019
Last Update Date: 10/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6306 HARFORD RD
BALTIMORE MD
21214-1349
US

IV. Provider business mailing address

6306 HARFORD RD
BALTIMORE MD
21214-1349
US

V. Phone/Fax

Practice location:
  • Phone: 410-254-3910
  • Fax: 410-254-3911
Mailing address:
  • Phone: 410-254-3910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. FESTUS ARAUWOU
Title or Position: PRESIDENT/CEO
Credential: CPA
Phone: 410-254-3910