NPI 1790011765

Summerville 2, LLC

Organisation Assisted Living Facility La Porte, IN

Practice location

Address: 2002 Andrew Ave, La Porte, IN 46350-6545
Phone: (219) 325-1599
Fax: (219) 362-1682
Mailing address: 3131 Elliott Ave Suite 500, Seattle, WA 98121-1044

Authorised official

Name: Noelle Diaz Bickel
Title: Licensing Specialist
Phone: (206) 298-2909

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence 07-010890-1 (IN)

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Registry record

NPI: 1790011765
Entity type: Organization
NPI issued: 27 Oct 2009
Record last updated: 27 Oct 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.