| NPI | 1982366118 |
|---|---|
| Former Legal Business Name | PINNACLE PEAK INTEGRATED CARE, LLC |
| Entity Type | Organization |
| Authorized Contact | TYLER TISDALE CEO 480-430-6744 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2022-11-11 |