Summerville at Mentor LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

2252R Issued in OH

Legal business name

SUMMERVILLE AT MENTOR LLC

Practice address

5700 Emerald CT
Mentor, OH 44060-1870

Phone

(440) 354-5499

Fax

(440) 354-5422

NPI assigned

Oct 23, 2009

Organization subpart

Yes

Parent organization

SUMMERVILLE SENIOR LIVING, INC.As reported in NPPES

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

Authorized official

Name

Noelle Diaz Bickel

Title

Licensing Specialist

Phone

(206) 298-2909

Specialties & licenses 2

Addresses

Other names 1

• Summerville at Mentor Doing business as

Part of

Summerville at St Augustine LLC

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

{
    "created_epoch": "1256256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256256000000",
    "number": "1831425925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 ELLIOTT AVE",
            "address_2": "SUITE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211044",
            "telephone_number": "206-298-2909",
            "fax_number": "206-301-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 EMERALD CT",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440601870",
            "telephone_number": "440-354-5499",
            "fax_number": "440-354-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERVILLE AT MENTOR LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMERVILLE SENIOR LIVING, INC.",
        "enumeration_date": "2009-10-23",
        "last_updated": "2009-10-23",
        "status": "A",
        "authorized_official_last_name": "BICKEL",
        "authorized_official_first_name": "NOELLE",
        "authorized_official_middle_name": "DIAZ",
        "authorized_official_title_or_position": "LICENSING SPECIALIST",
        "authorized_official_telephone_number": "206-298-2909"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "2252R",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "OH",
            "license": "2252R",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summerville at Mentor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Debbie Crawford Sturm, LPCC (OH), LPC (VA)
• Suhas LLC
• Suhas LLC
• Michele Ann Sulak, LPN
• Ezra Sullivan Zidonis
• Gina M Sumpter, NP
• Nicole Super
• Nicol Marie Susel
• Sustaining Angels Home Care, LLC
• Michelle Lorraine Sutter, LPN

• Assisted Living Facility in Mentor, OH
• Providers in Mentor, OH by specialty
• Assisted Living Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2009; 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.