Provider Demographics
NPI:1912673765
Name:SUMMIT CARE, LLC
Entity Type:Organization
Organization Name:SUMMIT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:DELUCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-268-1679
Mailing Address - Street 1:16101 HONEY BEAR CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-6910
Mailing Address - Country:US
Mailing Address - Phone:907-268-1679
Mailing Address - Fax:
Practice Address - Street 1:12631 ESTUARY CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99516-7316
Practice Address - Country:US
Practice Address - Phone:907-268-1679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility