MEDICARE: PINNACLE HEALTH FACILITIES XXXII LP

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	310400000X	Assisted Living Facility		KS
2	314000000X	Skilled Nursing Facility		KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205134582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE HEALTH FACILITIES XXXII LP

Provider Business Mailing Address
First Line	:	5420 W PLANO PKWY
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-4823
Country	:	US
Telephone Number	:	972-931-3800
Fax Number	:	972-931-3801

Provider Business Practice Location Address
First Line	:	620 E WOOD ST
Second Line	:
City	:	CLEARWATER
State	:	KS
Zip	:	67026-9757
Country	:	US
Telephone Number	:	620-584-2271
Fax Number	:	620-584-2277

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. THOMAS D SCOTT
Credential	:
Telephone Number	:	972-931-3800

Provider Enumeration Date	:	03/10/2011
Last Update Date	:	08/04/2011

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