Summit Silver Creek, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SUMMIT SILVER CREEK, LLC

Practice address

2046 125 T Ave NW
Watford City, ND 58854

Phone

(732) 580-1732

Fax

(701) 597-3004

NPI assigned

Apr 2, 2019

Organization subpart

No

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

Authorized official

Name

Matthew D'Alessandro

Title

Managing Partner

Phone

(732) 580-1732

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636934400000",
    "number": "1306308101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2046 125 T AVE NW",
            "city": "WATFORD CITY",
            "state": "ND",
            "postal_code": "58854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2046 125 T AVE NW",
            "city": "WATFORD CITY",
            "state": "ND",
            "postal_code": "58854",
            "telephone_number": "732-580-1732",
            "fax_number": "701-597-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT SILVER CREEK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-02",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-01",
        "status": "A",
        "authorized_official_last_name": "D'ALESSANDRO",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "732-580-1732"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Sanford, NP
• Afton McKenzie Schaper, FNP
• Desiree Sorenson
• Faith Stenberg
• Kristen Stenehjem
• Jessica Sweetser, FNP
• Jared Taylor
• Karen Thompson
• Tracy Beth Tomjack, D.O.
• Gary L Trauger, D.C.

• Substance Abuse Rehabilitation Facility in Watford City, ND
• Providers in Watford City, ND by specialty
• Substance Abuse Rehabilitation Facility in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.