Basic Information
| Provider Information | |||||||||
| NPI: | 1760939995 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUMMIT ACADEMY MANAGEMENT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2791 MOGADORE RD | ||||||||
| Address2: | |||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443121504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303694233 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2106 ARBOR AVE SE | ||||||||
| Address2: | |||||||||
| City: | WARREN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 444845225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303694233 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2016 | ||||||||
| LastUpdateDate: | 09/06/2016 | ||||||||
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| AuthorizedOfficialLastName: | GLASS | ||||||||
| AuthorizedOfficialFirstName: | ALLISON | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRINCIPAL | ||||||||
| AuthorizedOfficialTelephone: | 3303694233 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251K00000X | S.1303191 | OH | Y | Agencies | Public Health or Welfare |
No ID Information.