Provider Demographics
NPI:1962477943
Name:THE SUMMIT HEALTH & REHAB SERVICES, INC
Entity Type:Organization
Organization Name:THE SUMMIT HEALTH & REHAB SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-899-0325
Mailing Address - Street 1:4109 HWY 98 W
Mailing Address - Street 2:PO BOX 579
Mailing Address - City:SUMMIT
Mailing Address - State:MS
Mailing Address - Zip Code:39666
Mailing Address - Country:US
Mailing Address - Phone:888-899-0325
Mailing Address - Fax:601-276-3900
Practice Address - Street 1:4109 HWY 98 W
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:MS
Practice Address - Zip Code:39666
Practice Address - Country:US
Practice Address - Phone:888-899-0325
Practice Address - Fax:601-276-3900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03583531Medicaid
MS=========OtherBLUE CROSS OF MS PROVIDER
MS03583531Medicaid