Provider Demographics
NPI:1558995845
Name:SUMMERCREST ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:SUMMERCREST ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HAILEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WETHERBEE
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:603-863-8181
Mailing Address - Street 1:169 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:NH
Mailing Address - Zip Code:03773-1282
Mailing Address - Country:US
Mailing Address - Phone:603-863-8181
Mailing Address - Fax:603-863-8972
Practice Address - Street 1:169 SUMMER ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:NH
Practice Address - Zip Code:03773-1282
Practice Address - Country:US
Practice Address - Phone:603-863-8181
Practice Address - Fax:603-863-8972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility