MEDICARE: SUMMER CARES THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1609659499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMER CARES THERAPY

Provider Business Mailing Address
First Line	:	5320 TUPPER CT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-7650
Country	:	US
Telephone Number	:	719-354-0529
Fax Number	:

Provider Business Practice Location Address
First Line	:	5320 TUPPER CT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-7650
Country	:	US
Telephone Number	:	719-354-0529
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SUMMER GERDIS
Credential	:
Telephone Number	:	719-354-0529

Provider Enumeration Date	:	08/15/2023
Last Update Date	:	08/15/2023

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Directions to “SUMMER CARES THERAPY ” Practice Location

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