Summit Residential
LBN: Intermountain Centers For Human Development Inc.
Summit Residential is an health care organization with primary practice located at 2502 N Dodge Blvd Ste 190A , Tucson AZ 85716-2671. The organization recently has 2 registered licenses in different health care specialties including Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, Residential Treatment Facilities / Substance Abuse Treatment, Children. Residential Treatment Facilities / Substance Abuse Treatment, Children is the primary health care specialty.
Intermountain Centers For Human Development Inc. can be contacted via phone (520) 618-8800, or through Lopez, Rose via phone (520) 721-1887.
Contact Information
Primary practice address
2502 N Dodge Blvd Ste 190A
Tucson AZ 85716-2671
Phone: (520) 618-8800
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness | 320800000X | BH-4537 | Arizona |
| Residential Treatment Facilities / Substance Abuse Treatment, Children | 3245S0500X |
Profile Details
| NPI number | 1497135669 |
|---|---|
| LBN Legal business name | Intermountain Centers For Human Development Inc. |
| DBA Doing business as | Summit Residential |
| Authorized official | Lopez, Rose MBA, CPA |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 3rd, 2015 |
| Last updated | Dec 19th, 2023 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497135669 | NPPES |
| Arizona | Other | BH9011 | STATE LICENSE |
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