SUMMIT HOLISTIC CENTER LLC NPI 1942977244

NPI Information

NPI: 1942977244
Provider Name: SUMMIT HOLISTIC CENTER LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

CLIA Number: 21D2256024

Address:
6310 STEVENS FOREST RD STE 200
COLUMBIA, MD
ZIP 21046
Phone: (410) 245-2414
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SUMMIT HOLISTIC CENTER LLC is a mental health (including community mental health center) clinic center in Columbia, MD. SUMMIT HOLISTIC CENTER LLC NPI is 1942977244. The provider is registered as an organization entity type.

The provider's business location address is:

6310 STEVENS FOREST RD STE 200
COLUMBIA, MD
ZIP 21046-036
Phone: (410) 245-2414
Fax: (410) 740-9005

The provider's authorized official is Njideka Udochi .
The authorized official title is Owner and has the following contact phone number (410) 245-2414.

The CLIA number assigned to this NPI record is 21D2256024 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/24/2021 and was last updated on 2/9/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	D0051897	OTHER	MARYLAND	STATE LICENSE
2	685900300	MEDICAID	MARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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