Summer Street Community Services, Inc
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Adairsville, GA
NPI 1962843052 · NPPES record last updated Jun 17, 2014
Key facts
- NPI
- 1962843052
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- License
- CLA001245 (GA)
- Legal business name
- SUMMER STREET COMMUNITY SERVICES, INC
- Practice address
- 132 Summer St
Adairsville, GA 30103-2958 - Phone
- (770) 773-1904
- Fax
- (770) 773-1904
- NPI assigned
- Jul 17, 2013
- Organization subpart
- No
Authorized official
- Name
- Jackie Lynn Shain
- Title
- Director
- Phone
- (503) 949-0531
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | CLA001245 | GA | Yes |
Addresses
Primary practice location
132 Summer St
Adairsville, GA 30103-2958
Mailing address
132 Summer St
Adairsville, GA 30103-2958
Phone (770) 773-1904
Other providers in Adairsville, GA
- Deann Shelley
- Southern Smile Dental LLC
- Jacob Benjamin Stewart
- Darius Sturkey
- Robert Emmett Sullivan
- Nicole B. Swiger
- Daniel Tari
- Chelsea Boston Tehan
- Kailyn Sloan Thomas
- Rachel A Turner
All providers in Adairsville, GA · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.