Healthcare Provider Details

I. General information

NPI: 1568494581
Provider Name (Legal Business Name): SUMMERSLIVING SYSTEMS,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 09/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5514 W VIENNA RD
CLIO MI
48420-8273
US

IV. Provider business mailing address

PO BOX 46
CLIO MI
48420-0046
US

V. Phone/Fax

Practice location:
  • Phone: 810-687-0241
  • Fax: 810-687-4801
Mailing address:
  • Phone: 810-687-0241
  • Fax: 810-687-4801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberAS250010885
License Number StateMI

VIII. Authorized Official

Name: MISS LEOLA BARBRA SUMMERS
Title or Position: EXECUTIVE DIRECTOR
Credential: SOCIAL WPRKER
Phone: 810-687-0241