Provider Type Icon

SUMMER HILL ASSISTED LIVING LLC NPI 1689751919


NPI Information

NPI: 1689751919
Provider Name: SUMMER HILL ASSISTED LIVING, LLC

Doing Business As: SUMMER HILL

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 50D2077407

Address:
165 SW 6TH AVE
OAK HARBOR, WA
ZIP 98277
Phone: (360) 679-1400
Get Directions

SUMMER HILL ASSISTED LIVING, LLC is an assisted living facility in Oak Harbor, WA. 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. SUMMER HILL ASSISTED LIVING, LLC NPI is 1689751919. The provider is registered as an organization entity type.
The provider Is Doing Business As Summer Hill.

The provider's business location address is:

165 SW 6TH AVE
OAK HARBOR, WA
ZIP 98277-389
Phone: (360) 679-1400
Fax: (360) 675-2205

The provider's authorized official is John B Goodman .
The authorized official title is Chief Manager and has the following contact phone number (952) 361-8000.

The CLIA number assigned to this NPI record is 50D2077407 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living FacilityBH1839WASHINGTONYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1705314MEDICAIDWASHINGTON

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.