Provider Demographics
NPI:1760981427
Name:SUMMIT HOME HEALTH LLC
Entity Type:Organization
Organization Name:SUMMIT HOME HEALTH LLC
Other - Org Name:SUMMIT HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:LENICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-535-8255
Mailing Address - Street 1:7301 N 16TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5266
Mailing Address - Country:US
Mailing Address - Phone:602-535-8255
Mailing Address - Fax:602-666-0262
Practice Address - Street 1:7310 N 16TH ST STE 100B
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5259
Practice Address - Country:US
Practice Address - Phone:602-535-8255
Practice Address - Fax:602-666-0262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-08
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health