Provider Demographics
NPI:1255021101
Name:SUMMIT RETIREMENT INC.
Entity type:Organization
Organization Name:SUMMIT RETIREMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:CAREGIVER
Authorized Official - Phone:478-299-5614
Mailing Address - Street 1:634 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401
Mailing Address - Country:US
Mailing Address - Phone:478-419-1833
Mailing Address - Fax:478-419-1833
Practice Address - Street 1:634 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:SWAINSBORO
Practice Address - State:GA
Practice Address - Zip Code:30401
Practice Address - Country:US
Practice Address - Phone:478-419-1833
Practice Address - Fax:478-419-1833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility