Provider Demographics
NPI:1861206120
Name:SUMMERS, RYLEE FRANCIS SCOTT
Entity type:Individual
Prefix:
First Name:RYLEE
Middle Name:FRANCIS SCOTT
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 N 1ST ST APT 1
Mailing Address - Street 2:
Mailing Address - City:ONEILL
Mailing Address - State:NE
Mailing Address - Zip Code:68763-1184
Mailing Address - Country:US
Mailing Address - Phone:402-336-6355
Mailing Address - Fax:
Practice Address - Street 1:318 E HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:ONEILL
Practice Address - State:NE
Practice Address - Zip Code:68763-2104
Practice Address - Country:US
Practice Address - Phone:402-336-4405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
320900000X
NE251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities