SUMMIT SENIOR LIVING LLC NPI 1134487556

NPI Information

  • NPI: 1134487556
  • Provider Name: SUMMIT SENIOR LIVING, LLC
  • Classification: Assisted Living Facility - 3104A0630X
  • Specialization: Assisted Living, Behavioral Disturbances
  • Entity Type: Organization
  • Doing Business As: SUMMIT HILL SENIOR LIVING
  • CLIA Number: 24D2041371
  • Address: 1870 OLD HUDSON RD
    SAINT PAUL, MN
    ZIP 55119
  • Phone: (651) 451-4446

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NPI Details

SUMMIT SENIOR LIVING, LLC is an assisted living and behavioral disturbances assisted living facility in Saint Paul, MN. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. SUMMIT SENIOR LIVING, LLC NPI is 1134487556. The provider is registered as an organization entity type.
The provider Is Doing Business As Summit Hill Senior Living.

The provider's business location address is:

1870 OLD HUDSON RD
SAINT PAUL, MN
ZIP 55119-307
Phone: (651) 451-4446

The provider's authorized official is Kelly J Myers .
The authorized official title is Vp Of Operations and has the following contact phone number (651) 454-4801.

The CLIA number assigned to this NPI record is 24D2041371 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/24/2012 and was last updated on 4/24/2012.

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
13104A0630XAssisted Living FacilityAssisted Living, Behavioral DisturbancesYes

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This page was last updated on: 11/21/2025

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