Provider Demographics
NPI:1487685566
Name:SUMMIT ACRES INC.
Entity Type:Organization
Organization Name:SUMMIT ACRES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER/VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-498-5233
Mailing Address - Street 1:339 E MAPLE ST
Mailing Address - Street 2:STE 100
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-2593
Mailing Address - Country:US
Mailing Address - Phone:330-498-5233
Mailing Address - Fax:
Practice Address - Street 1:44565 SUNSET RD
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:OH
Practice Address - Zip Code:43724-9731
Practice Address - Country:US
Practice Address - Phone:740-732-5488
Practice Address - Fax:740-732-7816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6011314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0001938Medicaid
OH0001938Medicaid