Provider Demographics
NPI:1912154980
Name:SUMMIT PSYCHOLOGICAL ASSOCIATES, INC. JAIL
Entity Type:Organization
Organization Name:SUMMIT PSYCHOLOGICAL ASSOCIATES, INC. JAIL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-535-8181
Mailing Address - Street 1:37 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-1910
Mailing Address - Country:US
Mailing Address - Phone:330-535-8181
Mailing Address - Fax:330-535-9303
Practice Address - Street 1:205 E CROSIER ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-2351
Practice Address - Country:US
Practice Address - Phone:330-643-2171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMIT PSYCHOLOGICAL ASSOCIATES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-21
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty