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NPI Code Detail

MEDICARE: SUMMIT CONTRACT THERAPY CENTER, LLC

MEDICARE: SUMMIT CONTRACT THERAPY CENTER, LLC
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
1385H00000XRespite Care
2251E00000XHome Health Agency208277TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1208277OTHEROTA LICENSE

General Provider Information

NPI Number : 1669617510
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUMMIT CONTRACT THERAPY CENTER, LLC
Provider Business Mailing Address
First Line : 2331 NW MILITARY HWY
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78231-2502
Country : US
Telephone Number : 210-617-7716
Fax Number : 210-617-7716
Provider Business Practice Location Address
First Line : 2331 NW MILITARY HWY
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78231-2502
Country : US
Telephone Number : 210-617-7716
Fax Number : 210-617-7716
Authorized Official
Title or Position : OWNER, LICENSED OTA
Name : MRS. LESLIE HOUSE FRIEDEL
Credential : LOTA
Telephone Number : 210-725-2229
Provider Enumeration Date : 12/06/2008
Last Update Date : 09/25/2009

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Directions to “SUMMIT CONTRACT THERAPY CENTER, LLC ” Practice Location

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