Summit Professional Placements, Inc.

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

AS110299000 Issued in MI

Legal business name

SUMMIT PROFESSIONAL PLACEMENTS, INC.

Doing business as

Woodland Homes

Practice address

11165 US Highway 31
Berrien Springs, MI 49103-1547

Phone

(269) 815-5190

Fax

(269) 815-5281

NPI assigned

Oct 8, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ledenila Tago Fonner

Title

President/Secretary

Phone

(269) 815-5190

Specialties & licenses 1

Addresses

Other names 1

• Woodland Homes Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1381190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381190400000",
    "number": "1023445988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11165 US HIGHWAY 31",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031547",
            "telephone_number": "269-815-5190",
            "fax_number": "269-815-5281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11165 US HIGHWAY 31",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031547",
            "telephone_number": "269-815-5190",
            "fax_number": "269-815-5281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT PROFESSIONAL PLACEMENTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-08",
        "last_updated": "2013-10-08",
        "status": "A",
        "authorized_official_last_name": "FONNER",
        "authorized_official_first_name": "LEDENILA",
        "authorized_official_middle_name": "TAGO",
        "authorized_official_title_or_position": "PRESIDENT/SECRETARY",
        "authorized_official_telephone_number": "269-815-5190"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "MI",
            "license": "AS110299000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodland Homes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Custodial Care Facility in Berrien Springs, MI
• Providers in Berrien Springs, MI by specialty
• Custodial Care Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.