Provider Demographics
NPI:1992733695
Name:SUMMIT ACRES HOME CARE INC
Entity type:Organization
Organization Name:SUMMIT ACRES HOME CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP BILLING
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:L
Authorized Official - Last Name:HULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-498-8047
Mailing Address - Street 1:PO BOX 519
Mailing Address - Street 2:
Mailing Address - City:GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:44232-0519
Mailing Address - Country:US
Mailing Address - Phone:330-498-8047
Mailing Address - Fax:
Practice Address - Street 1:39 SUMMIT CT
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:OH
Practice Address - Zip Code:43724-9033
Practice Address - Country:US
Practice Address - Phone:740-732-5712
Practice Address - Fax:740-732-7350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2570098Medicaid
OH0969555Medicaid
OH0183813Medicaid
OH2570098Medicaid
OH0915500001Medicare NSC