SUMMERVILLE I LLC NPI 1336376466

NPI Information

  • NPI: 1336376466
  • Provider Name: SUMMERVILLE I, LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: SUMMERVILLE AT WOODWARD ESTATE
  • CLIA Number: 21D2202194
  • Address: 14997 HEALTH CENTER DR
    BOWIE, MD
    ZIP 20716
  • Phone: (301) 464-4400

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NPI Details

SUMMERVILLE I, LLC is an assisted living facility in Bowie, MD. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. SUMMERVILLE I, LLC NPI is 1336376466. The provider is registered as an organization entity type.
The provider Is Doing Business As Summerville At Woodward Estate.

The provider's business location address is:

14997 HEALTH CENTER DR
BOWIE, MD
ZIP 20716-082
Phone: (301) 464-4400
Fax: (301) 464-4380

The provider's authorized official is Noelle Diaz .
The authorized official title is Licensing Specialist and has the following contact phone number (206) 301-4060.

The CLIA number assigned to this NPI record is 21D2202194 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/16/2009 and was last updated on 6/16/2009.

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
1310400000XAssisted Living Facility16AL0748MARYLANDYes

What is NPI?

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

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