Summit BHC Jacksonville LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

SUMMIT BHC JACKSONVILLE LLC

Practice address

4100 Southpoint Dr E Ste 1
Jacksonville, FL 32216-8710

Phone

(866) 283-7122

NPI assigned

Feb 5, 2024

Last updated

Feb 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul Gilbert

Title

Chief Legal Officer

Phone

(615) 716-4924

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1235992900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 CORPORATE CENTRE DR STE 600",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370672784",
            "telephone_number": "615-716-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 SOUTHPOINT DR E STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168710",
            "telephone_number": "866-283-7122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT BHC JACKSONVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "615-716-4924"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lesley Nicole Summers, MAT, MA, CCC-SLP
• Millely Josefina Summers
• Sarahlynn Chantelle Summers, RN, BSN
• Summerville at Mandarin, LLC (Brookdale Mandarin)
• Jeanie Summerville, ARNP, CNM
• Summit Emergency Physicians, LLC
• Summit Emergency Physicians, LLC
• Summit Integrative Health, LLC
• Summit Medical Transportation. LLC
• Summit Vision Inc. (New Town Pharmacy)

• Substance Use Disorder Rehabilitation Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.