Provider Demographics
NPI:1265618854
Name:SUMMIT BUILDERS
Entity type:Organization
Organization Name:SUMMIT BUILDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:DENAE
Authorized Official - Last Name:JAHDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-762-3746
Mailing Address - Street 1:1247 160TH ST
Mailing Address - Street 2:
Mailing Address - City:ADAIR
Mailing Address - State:IA
Mailing Address - Zip Code:50002-8035
Mailing Address - Country:US
Mailing Address - Phone:712-762-3746
Mailing Address - Fax:
Practice Address - Street 1:1247 160TH ST
Practice Address - Street 2:
Practice Address - City:ADAIR
Practice Address - State:IA
Practice Address - Zip Code:50002-8035
Practice Address - Country:US
Practice Address - Phone:712-762-3746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2452197G251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable