Provider Demographics
NPI:1922283340
Name:SUMMIT SUPPORT SERVICES OF ASHE, INC
Entity Type:Organization
Organization Name:SUMMIT SUPPORT SERVICES OF ASHE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:ANDERSON
Authorized Official - Last Name:ROGNSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-846-4491
Mailing Address - Street 1:PO BOX 381
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28640-0381
Mailing Address - Country:US
Mailing Address - Phone:336-846-4491
Mailing Address - Fax:336-846-4927
Practice Address - Street 1:342 LONG ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28640-9789
Practice Address - Country:US
Practice Address - Phone:336-846-4491
Practice Address - Fax:336-846-4927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251B00000XAgenciesCase Management
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7804402Medicaid