Provider Demographics
NPI:1891547626
Name:RESIDENTIAL CARE AT THE SUMMIT, LLC
Entity Type:Organization
Organization Name:RESIDENTIAL CARE AT THE SUMMIT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-472-2869
Mailing Address - Street 1:2501 E SEMINARY DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76119-5602
Mailing Address - Country:US
Mailing Address - Phone:817-882-6200
Mailing Address - Fax:
Practice Address - Street 1:2501 E SEMINARY DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76119-5602
Practice Address - Country:US
Practice Address - Phone:817-882-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No305S00000XManaged Care OrganizationsPoint of Service
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No347C00000XTransportation ServicesPrivate Vehicle