Provider Demographics
NPI:1124201637
Name:SUMMIT TREATMENT SERVICES, INC.
Entity Type:Organization
Organization Name:SUMMIT TREATMENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAROD
Authorized Official - Middle Name:B
Authorized Official - Last Name:THIELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-717-1765
Mailing Address - Street 1:17060 W 64TH DR
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80007-6823
Mailing Address - Country:US
Mailing Address - Phone:303-717-1765
Mailing Address - Fax:303-424-9351
Practice Address - Street 1:100 LOGAN ST
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-2408
Practice Address - Country:US
Practice Address - Phone:970-522-7534
Practice Address - Fax:970-522-7080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1547948320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness