Organization
NKY MED, LLC
Active
Parent organization
PINNACLE TREATMENT CENTERS, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PINNACLE TREATMENT CENTERS, INC
Authorized official
ROBYN TANIS (EXECUTIVE DIRECTOR OF CONTRACT MGMT)
(856) 533-8762
Entity
Organization
Contact information
Practice address
1717 MADISON AVE, COVINGTON, KY 41011-3330
(859) 360-0250
Mailing address
1317 ROUTE 73 STE 200, MOUNT LAUREL, NJ 08054-2202
(856) 439-6111
(856) 780-5153
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
810355
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
810355
STATE LICNESE
KY
Enumeration date
05/19/2014
Last updated
12/20/2019
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