Provider Demographics
NPI:1679043848
Name:SUMMIT HEALTH DEVELOPMENT, LLC
Entity Type:Organization
Organization Name:SUMMIT HEALTH DEVELOPMENT, LLC
Other - Org Name:AIDEN HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRCOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:361-861-5059
Mailing Address - Street 1:3210 REID DR STE C
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2524
Mailing Address - Country:US
Mailing Address - Phone:361-861-5059
Mailing Address - Fax:361-239-5087
Practice Address - Street 1:3210 REID DR STE C
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2524
Practice Address - Country:US
Practice Address - Phone:361-861-5059
Practice Address - Fax:361-239-5087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child