MEDICARE: SUMMIT COMMUNITY HEALTH, INC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1154218691
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT COMMUNITY HEALTH, INC

Provider Business Mailing Address
First Line	:	5008 EDMONDSON AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21229-2332
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3308 W NORTH AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21216-3018
Country	:	US
Telephone Number	:	410-246-1508
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF PROGRAMS
Name	:	CHRISTINA L KUEHNE
Credential	:	LMSW
Telephone Number	:	410-961-1866

Provider Enumeration Date	:	06/18/2025
Last Update Date	:	06/18/2025

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Directions to “SUMMIT COMMUNITY HEALTH, INC ” Practice Location

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