Provider Demographics
NPI:1912163015
Name:THE SUMMIT CENTER
Entity Type:Organization
Organization Name:THE SUMMIT CENTER
Other - Org Name:SUMMIT EDUCATIONAL RESOURCES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOTI
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:716-629-3450
Mailing Address - Street 1:150 STAHL ROAD
Mailing Address - Street 2:
Mailing Address - City:GETZVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14068-1231
Mailing Address - Country:US
Mailing Address - Phone:716-629-3430
Mailing Address - Fax:716-629-3494
Practice Address - Street 1:150 STAHL ROAD
Practice Address - Street 2:
Practice Address - City:GETZVILLE
Practice Address - State:NY
Practice Address - Zip Code:14068-1231
Practice Address - Country:US
Practice Address - Phone:716-629-3430
Practice Address - Fax:716-629-3494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03045241Medicaid
NY03257307Medicaid
NY02592143Medicaid
NY01818482Medicaid
NY02004213Medicaid
NY02367040Medicaid