Provider Demographics
NPI:1578691333
Name:SUMMIT CARE AND WELLNESS TREATMENT AND COUNSELING, PC
Entity Type:Organization
Organization Name:SUMMIT CARE AND WELLNESS TREATMENT AND COUNSELING, PC
Other - Org Name:SUMMIT LIFE RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/DIRECTOR/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANETTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GINGERY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHP, LADC, LPC
Authorized Official - Phone:402-435-2273
Mailing Address - Street 1:1700 S 24TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-3003
Mailing Address - Country:US
Mailing Address - Phone:402-435-2273
Mailing Address - Fax:
Practice Address - Street 1:1700 S 24TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-3003
Practice Address - Country:US
Practice Address - Phone:402-435-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMIT CARE AND WELLNESS TREATMENT AND COUNSELING, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE208494938101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty