Healthcare Provider Details

I. General information

NPI: 1467333005
Provider Name (Legal Business Name): PINNACLE ASSISTED LIVING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 W BLACKHAWK DR
FORT ATKINSON WI
53538-1025
US

IV. Provider business mailing address

146 S CHURCH ST
WHITEWATER WI
53190-1950
US

V. Phone/Fax

Practice location:
  • Phone: 920-397-2944
  • Fax:
Mailing address:
  • Phone: 920-397-2944
  • Fax: 262-458-2422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. GILDO JOSE GORNIAK
Title or Position: OWNER, CFO
Credential:
Phone: 920-397-2944