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General NPI Number Information
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NPI Number | 1710217070
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Entity Type | Organization
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Legal Business Name | PINNACLE ASSISTED LIVING
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Dates
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Enumeration Date | 01/10/2010
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Last Update Date | 01/10/2010
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Provider Practice Location Address
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Address Line | 341 SQUIREBROOK DR
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City | DESOTO
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State | TX
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Zip | 75115-2914
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Country | US
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Telephone | 972-697-5461
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Fax | 888-847-8217
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Provider Business Mailing Address
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Address Line | 341 SQUIREBROOK DR
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City | DESOTO
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State | TX
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Zip | 75115-2914
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Country | US
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Telephone | 972-697-5461
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Fax | 888-847-8217
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | WENHUA MA
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Credential |
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Telephone | 972-697-5461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 128653
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License Number State | TX
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