Basic Information
| Provider Information | |||||||||
| NPI: | 1104010602 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUMMIT ACADEMY MIDDLE SCHOOL YOUNGSTOWN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1111 W MARKET ST | ||||||||
| Address2: | |||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443137122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308366200 | ||||||||
| FaxNumber: | 3308368216 | ||||||||
| Practice Location | |||||||||
| Address1: | 810 OAK ST | ||||||||
| Address2: | |||||||||
| City: | YOUNGSTOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 445061233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307439235 | ||||||||
| FaxNumber: | 3307439260 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2007 | ||||||||
| LastUpdateDate: | 08/29/2007 | ||||||||
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| AuthorizedOfficialLastName: | HOLZAPFEL | ||||||||
| AuthorizedOfficialFirstName: | GERALD | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 3308366200 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251300000X | Y | Agencies | Local Education Agency (LEA) |
No ID Information.