Provider Demographics
NPI: | 1457020240 |
---|---|
Name: | SUMMER WISDOM ASSOCIATES INC |
Entity Type: | Organization |
Organization Name: | SUMMER WISDOM ASSOCIATES INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OFFICE ASSISTANT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | FITZROY EMMANUEL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | WARDE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 833-502-9751 |
Mailing Address - Street 1: | 7603 GEORGIA AVE NW STE 205 |
Mailing Address - Street 2: | |
Mailing Address - City: | WASHINGTON |
Mailing Address - State: | DC |
Mailing Address - Zip Code: | 20012-1617 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 833-502-9751 |
Mailing Address - Fax: | 202-914-5627 |
Practice Address - Street 1: | 7603 GEORGIA AVE NW STE 205 |
Practice Address - Street 2: | |
Practice Address - City: | WASHINGTON |
Practice Address - State: | DC |
Practice Address - Zip Code: | 20012-1617 |
Practice Address - Country: | US |
Practice Address - Phone: | 833-502-9751 |
Practice Address - Fax: | 202-914-5627 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-09-07 |
Last Update Date: | 2021-09-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 253Z00000X | Agencies | In Home Supportive Care | |
No | 251B00000X | Agencies | Case Management | |
No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | |
No | 251E00000X | Agencies | Home Health | |
No | 251G00000X | Agencies | Hospice Care, Community Based | |
No | 251S00000X | Agencies | Community/Behavioral Health | |
No | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | |
No | 3104A0625X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Mental Illness |
No | 3104A0630X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Behavioral Disturbances |
No | 310500000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Mental Illness | |
No | 385H00000X | Respite Care Facility | Respite Care | |
No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child |
No | 385HR2065X | Respite Care Facility | Respite Care | Respite Care, Physical Disabilities, Child |