Organization
PINNACLE SOBER LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD S MARTINS (CEO)
(754) 779-4574
Entity
Organization
Contact information
Practice address
1561 NE 44TH ST, POMPANO BEACH, FL 33064-5868
(754) 779-4574
Mailing address
1561 NE 44TH ST, POMPANO BEACH, FL 33064-5868
(784) 779-4574
(954) 532-4048
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
10D2035945
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19D2935845
CLIA WAIVER
FL
Enumeration date
04/25/2012
Last updated
07/23/2013
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