Provider Demographics
NPI:1649782988
Name:SUMMIT SUPPORT SERVICES LLC
Entity type:Organization
Organization Name:SUMMIT SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGIUSEPPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-778-1018
Mailing Address - Street 1:860 US ROUTE 2 E UNIT 2
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:ME
Mailing Address - Zip Code:04294-3864
Mailing Address - Country:US
Mailing Address - Phone:207-778-1018
Mailing Address - Fax:
Practice Address - Street 1:860 US ROUTE 2 E UNIT 2
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:ME
Practice Address - Zip Code:04294-3864
Practice Address - Country:US
Practice Address - Phone:207-778-1018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty