Provider Demographics
NPI:1881791168
Name:SUMMER SKY, INC.
Entity type:Organization
Organization Name:SUMMER SKY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCDC
Authorized Official - Phone:254-968-2907
Mailing Address - Street 1:1100 N. MCCART STREET
Mailing Address - Street 2:
Mailing Address - City:STEPHENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76401-2430
Mailing Address - Country:US
Mailing Address - Phone:254-968-2907
Mailing Address - Fax:254-968-4509
Practice Address - Street 1:1100 N. MCCART STREET
Practice Address - Street 2:
Practice Address - City:STEPHENVILLE
Practice Address - State:TX
Practice Address - Zip Code:76401-2430
Practice Address - Country:US
Practice Address - Phone:254-968-2907
Practice Address - Fax:254-968-4509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX179-A324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179-AOtherDSHS-CHEMICAL DEPENDEN
TX179-AOtherCHEMICAL DEPENDENCY