Provider Demographics
NPI:1881823722
Name:SUMMIT POINTE
Entity Type:Organization
Organization Name:SUMMIT POINTE
Other - Org Name:BEHAVIORAL HEALTH RESOURCES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-966-1460
Mailing Address - Street 1:3630 CAPITAL AVE SW
Mailing Address - Street 2:STE 1
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-7375
Mailing Address - Country:US
Mailing Address - Phone:269-979-8333
Mailing Address - Fax:269-979-7766
Practice Address - Street 1:3630 CAPITAL AVE SW
Practice Address - Street 2:STE 1
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-7375
Practice Address - Country:US
Practice Address - Phone:269-979-8333
Practice Address - Fax:269-979-7766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301061377207Q00000X
MI4301048453207R00000X
MI4301059007207R00000X
MI51010115742084P0800X
MI43010453202084P0800X
MI43010466292084P0800X
MI43010587022084P0800X
MI251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M43520OtherMEDICARE
MI0A30027OtherBCBS OF MICHIGAN