Provider Demographics
NPI:1588048177
Name:SUMMIT CARE AND WELLNESS TREATMENT AND COUNSELING, PC
Entity type:Organization
Organization Name:SUMMIT CARE AND WELLNESS TREATMENT AND COUNSELING, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GINGERY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHP, LPC, LADC, ACC
Authorized Official - Phone:402-435-2273
Mailing Address - Street 1:9300 WAGON TRAIN RD
Mailing Address - Street 2:
Mailing Address - City:HICKMAN
Mailing Address - State:NE
Mailing Address - Zip Code:68372-9877
Mailing Address - Country:US
Mailing Address - Phone:402-792-0097
Mailing Address - Fax:402-792-0098
Practice Address - Street 1:9300 WAGON TRAIN RD
Practice Address - Street 2:
Practice Address - City:HICKMAN
Practice Address - State:NE
Practice Address - Zip Code:68372-9877
Practice Address - Country:US
Practice Address - Phone:402-792-0097
Practice Address - Fax:402-792-0098
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMIT CARE AND WELLNESS TREATMENT AND COUNSELING, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NESATC149324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1578691333OtherNPI FOR OUTPATIENT PRACTICE LOCATION