Provider Demographics
NPI:1568494581
Name:SUMMERSLIVING SYSTEMS,INC.
Entity Type:Organization
Organization Name:SUMMERSLIVING SYSTEMS,INC.
Other - Org Name:SHUMPERT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LEOLA
Authorized Official - Middle Name:BARBRA
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:SOCIAL WPRKER
Authorized Official - Phone:810-687-0241
Mailing Address - Street 1:PO BOX 46
Mailing Address - Street 2:
Mailing Address - City:CLIO
Mailing Address - State:MI
Mailing Address - Zip Code:48420-0046
Mailing Address - Country:US
Mailing Address - Phone:810-687-0241
Mailing Address - Fax:810-687-4801
Practice Address - Street 1:5514 W VIENNA RD
Practice Address - Street 2:
Practice Address - City:CLIO
Practice Address - State:MI
Practice Address - Zip Code:48420-8273
Practice Address - Country:US
Practice Address - Phone:810-687-0241
Practice Address - Fax:810-687-4801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS250010885311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700752OtherCORPORATION I.D. NUMBER