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General NPI Number Information
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NPI Number | 1124201637
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Entity Type | Organization
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Legal Business Name | SUMMIT TREATMENT SERVICES, INC.
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 100 LOGAN ST
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City | STERLING
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State | CO
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Zip | 80751-2408
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Country | US
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Telephone | 970-522-7534
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Fax | 970-522-7080
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Provider Business Mailing Address
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Address Line | 17060 W 64TH DR
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City | ARVADA
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State | CO
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Zip | 80007-6823
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Country | US
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Telephone | 303-717-1765
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Fax | 303-424-9351
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAROD B. THIELE
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Credential |
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Telephone | 303-717-1765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 1547948
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License Number State | CO
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