Organization
PINNACLE TREATMENT CENTERS VA-I, LLC
Active
Other names
FCCR Southlake, FCCR Soutlake
Organization subpart
No
Provider details
NPI number
Authorized official
ROBYN TANIS (EXEC DIR CONTRACT MANAGEMENT)
(856) 533-8762
Entity
Organization
Contact information
Practice address
905 SOUTHLAKE BLVD, SUITES A & C, NORTH CHESTERFIELD, VA 23236-3955
(804) 354-1996
Mailing address
1317 ROUTE 73, MOUNT LAUREL, NJ 08054-2202
(856) 533-8762
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM2800X
Methadone Clinic
Primary
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
Other
Enumeration date
11/14/2017
Last updated
11/21/2023
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