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General NPI Number Information
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NPI Number | 1316372899
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Entity Type | Organization
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Legal Business Name | PINNACLE TREATMENT CENTERS, LLC D/B/A RECOVERY WORKS PADUCAH
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Dates
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Enumeration Date | 09/04/2013
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Last Update Date | 09/23/2020
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Provider Practice Location Address
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Address Line | 4747 OLD DUBLIN RD
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City | MAYFIELD
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State | KY
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Zip | 42066-8404
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Country | US
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Telephone | 270-623-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 1317 ROUTE 73 STE 200
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City | MOUNT LAUREL
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State | NJ
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Zip | 08054-2202
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Country | US
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Telephone | 856-439-6111
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Fax | 502-867-7978
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR OF CONTRACT MGMT
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Name | ROBYN TANIS
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Credential |
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Telephone | 856-533-8762
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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