Provider Demographics
NPI:1275841736
Name:SUMMIT SERVICES LLC
Entity Type:Organization
Organization Name:SUMMIT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:P
Authorized Official - Last Name:BEIERMEISTER
Authorized Official - Suffix:
Authorized Official - Credentials:LISAC
Authorized Official - Phone:520-808-1403
Mailing Address - Street 1:4411 E 5TH ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-2015
Mailing Address - Country:US
Mailing Address - Phone:520-808-1403
Mailing Address - Fax:
Practice Address - Street 1:4411 E 5TH ST
Practice Address - Street 2:SUITE E
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2015
Practice Address - Country:US
Practice Address - Phone:520-808-1403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3673251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management