MEDICARE: PINNACLE RECOVERY CENTERS LLC

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	261QM0850X	Adult Mental Health Clinic/Center
2	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1295585065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE RECOVERY CENTERS LLC

Provider Business Mailing Address
First Line	:	7917 N MAY AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-4540
Country	:	US
Telephone Number	:	702-903-9847
Fax Number	:	702-725-4994

Provider Business Practice Location Address
First Line	:	7917 N MAY AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-4540
Country	:	US
Telephone Number	:	702-903-9847
Fax Number	:	702-725-4994

Authorized Official
Title or Position	:	BILLING DIRECTOR
Name	:	MS. THI HOANG
Credential	:
Telephone Number	:	702-205-8232

Provider Enumeration Date	:	03/25/2024
Last Update Date	:	01/13/2025

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