MEDICARE: PINNACLE DETOX & RECOVERY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1063230001
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE DETOX & RECOVERY, INC.

Provider Business Mailing Address
First Line	:	202 W LEMON AVE
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91007-8031
Country	:	US
Telephone Number	:	747-444-7477
Fax Number	:

Provider Business Practice Location Address
First Line	:	202 W LEMON AVE
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91007-8031
Country	:	US
Telephone Number	:	747-444-7477
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	FARES HAFFAR
Credential	:
Telephone Number	:	747-444-7477

Provider Enumeration Date	:	09/30/2024
Last Update Date	:	05/14/2026

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