Provider Demographics
NPI:1497917371
Name:SUMMIT ACHIEVEMENT OF STOW
Entity Type:Organization
Organization Name:SUMMIT ACHIEVEMENT OF STOW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:OYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-697-2020
Mailing Address - Street 1:69 DEER HILL RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:ME
Mailing Address - Zip Code:04037-3100
Mailing Address - Country:US
Mailing Address - Phone:207-697-2020
Mailing Address - Fax:207-697-2021
Practice Address - Street 1:69 DEER HILL RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:ME
Practice Address - Zip Code:04037-3100
Practice Address - Country:US
Practice Address - Phone:207-697-2020
Practice Address - Fax:207-697-2021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME216716322D00000X, 3245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children