Provider Demographics
NPI:1801648803
Name:SUMMIT ACHIEVEMENT OF STOW, INC.
Entity type:Organization
Organization Name:SUMMIT ACHIEVEMENT OF STOW, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ERNST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-697-2020
Mailing Address - Street 1:69 DEER HILL RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:ME
Mailing Address - Zip Code:04037-3100
Mailing Address - Country:US
Mailing Address - Phone:207-697-2020
Mailing Address - Fax:207-697-2021
Practice Address - Street 1:69 DEER HILL RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:ME
Practice Address - Zip Code:04037-3100
Practice Address - Country:US
Practice Address - Phone:207-697-2020
Practice Address - Fax:207-697-2021
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMIT ACHIEVEMENT OF STOW, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty