Provider Demographics
NPI:1477293082
Name:SUMMER SPRINGS BOARD AND CARE, LLC
Entity Type:Organization
Organization Name:SUMMER SPRINGS BOARD AND CARE, LLC
Other - Org Name:SUMMER SPRINGS BOARD AND CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIO
Authorized Official - Middle Name:VITUG
Authorized Official - Last Name:TELMO
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:661-246-8702
Mailing Address - Street 1:6112 SUMMER SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-5216
Mailing Address - Country:US
Mailing Address - Phone:661-246-8702
Mailing Address - Fax:
Practice Address - Street 1:6112 SUMMER SPRINGS DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-5216
Practice Address - Country:US
Practice Address - Phone:661-246-8703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-31
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA157204221OtherDEPARTMENT OF SOCIAL SERVICES
CA157209196OtherDEPARTMENT OF SOCIAL SERVICES
CA157209299OtherDEPARTMENT OF SOCIAL SERVICES