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NPI Code Detail

MEDICARE: SUMMITVIEW CHILD & FAMILY SERVICES, INC.

MEDICARE: SUMMITVIEW CHILD & FAMILY SERVICES, 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
1320800000XMental Illness Community Based Residential Treatment Facility097005505CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1097005505OTHERCAMEDI-CAL

General Provider Information

NPI Number : 1912397126
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUMMITVIEW CHILD & FAMILY SERVICES, INC.
Provider Business Mailing Address
First Line : 4805 GOLDEN FOOTHILL PKWY
Second Line :
City : EL DORADO HILLS
State : CA
Zip : 95762-9651
Country : US
Telephone Number : 530-644-2412
Fax Number : 530-644-8563
Provider Business Practice Location Address
First Line : 4805 GOLDEN FOOTHILL PKWY
Second Line :
City : EL DORADO HILLS
State : CA
Zip : 95762-9651
Country : US
Telephone Number : 530-644-2412
Fax Number : 530-644-8563
Authorized Official
Title or Position : DIRECTOR OF FINANCE & OPERATIONS
Name : COURTNEY TOMBLIN
Credential :
Telephone Number : 530-485-3374
Provider Enumeration Date : 01/26/2015
Last Update Date : 09/30/2024

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