Provider Demographics
NPI:1407021546
Name:UHS OF SUMMITRIDGE, LLC
Entity Type:Organization
Organization Name:UHS OF SUMMITRIDGE, LLC
Other - Org Name:SUMMITRIDGE CENTER FOR PSYCHIATRY &ADDICTIVE MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-768-3300
Mailing Address - Street 1:250 SCENIC HWY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-5675
Mailing Address - Country:US
Mailing Address - Phone:678-442-5800
Mailing Address - Fax:
Practice Address - Street 1:250 SCENIC HWY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-5675
Practice Address - Country:US
Practice Address - Phone:678-442-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA114004Medicare Oscar/Certification