Provider Demographics
NPI:1952168213
Name:SUMMIT CAMP
Entity Type:Organization
Organization Name:SUMMIT CAMP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:570-253-4381
Mailing Address - Street 1:168 DUCK HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-6608
Mailing Address - Country:US
Mailing Address - Phone:570-253-4381
Mailing Address - Fax:
Practice Address - Street 1:168 DUCK HARBOR RD
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-6608
Practice Address - Country:US
Practice Address - Phone:570-253-4381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2050XRespite Care FacilityRespite CareRespite Care Camp
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child