Organization
PINNACLE PEAK RECOVERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER TISDALE (OWNER)
(480) 750-1200
Entity
Organization
Contact information
Practice address
8070 E MORGAN TRL, SUITE 200, SCOTTSDALE, AZ 85258-1227
(954) 746-8232
Mailing address
8070 E MORGAN TRL, SUITE 200, SCOTTSDALE, AZ 85258-1227
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IFBH10502
BEHAVIORAL HEALTH INPATIENT FACILITY
AZ
01
—
OTC7476
OUTPATIENT TREATMENT CENTER
AZ
Enumeration date
12/28/2015
Last updated
02/09/2023
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