Healthcare Provider Details

I. General information

NPI: 1487685566
Provider Name (Legal Business Name): SUMMIT ACRES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 09/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44565 SUNSET RD
CALDWELL OH
43724-9731
US

IV. Provider business mailing address

339 E MAPLE ST STE 100
NORTH CANTON OH
44720-2593
US

V. Phone/Fax

Practice location:
  • Phone: 740-732-5488
  • Fax: 740-732-7816
Mailing address:
  • Phone: 330-498-5233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number6011
License Number StateOH

VIII. Authorized Official

Name: KATHLEEN R JOHNSON
Title or Position: TREASURER/VP FINANCE
Credential:
Phone: 330-498-5233