Provider Demographics
NPI:1902890882
Name:SUMMIT HOME HEALTH CARE INC
Entity type:Organization
Organization Name:SUMMIT HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:PERREAULT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-533-0084
Mailing Address - Street 1:6455 N UNION BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-5852
Mailing Address - Country:US
Mailing Address - Phone:719-533-0084
Mailing Address - Fax:719-533-0466
Practice Address - Street 1:6455 N UNION BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-5852
Practice Address - Country:US
Practice Address - Phone:719-533-0084
Practice Address - Fax:719-533-0466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05702113Medicaid
CO05702113Medicaid