Healthcare Provider Details
I. General information
NPI: 1831018480
Provider Name (Legal Business Name): PINNACLE TREATMENT CENTERS VA-I, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1801 HULL ST
RICHMOND VA
23224-3721
US
IV. Provider business mailing address
1317 ROUTE 73 STE 200
MOUNT LAUREL NJ
08054-2202
US
V. Phone/Fax
- Phone: 804-964-2948
- Fax: 804-315-1772
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2800X |
| Taxonomy | Methadone Clinic |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBYN
TANIS
Title or Position: EXECUTIVE DIRECTOR CONTRACT MANAGEM
Credential: TANIS
Phone: 856-533-8762