SUMMERVILLE 2, LLC (NPI# 1568799138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568799138 |
| Entity Type | Organization |
| Organization Name | SUMMERVILLE 2, LLC |
| Other Organization Name | BRENTWOOD AT HOBART |
| Practice Address |
1147 South 3rd Street Hobart IN 46342-4956 |
| Mailing Address |
3131 Elliott Ave Suite 500 Seattle WA 98121-1044 |
| Practice Telephone | 2199451968 |
| Practice Fax Number | 2199451219 |
| Mailing Telephone | 2062982909 |
| Mailing Fax Number | 2063014500 |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2009-11-03 |
| Authorized Official Name | NOELLE DIAZ BICKEL (LICENSING SPECIALIST) |
| Authorized Official Telephone | 2062982909 |
| Is Organization Subpart | Y |
| Parent Organization Name | SUMMERVILLE INVESTORS, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 07-010890-1 | IN | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Brentwood at Hobart | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639405608 | Summerville 2, LLC | Assisted Living Facility | 1147 S 3rd St, Niles, MI 49120-3459 | 2009-10-27 |
| 1790011765 | Summerville 2, LLC | Assisted Living Facility | 2002 Andrew Ave, La Porte, IN 46350-6545 | 2009-10-27 |
| Street Address |
1147 SOUTH 3RD STREET |
| City | HOBART |
| State | IN |
| Zip Code | 46342-4956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952734295 | Carleen Kaucky | Nurse Practitioner | 1445 South Lake Park Ave, Hobart, IN 46342 | 2013-08-09 |
| 1679827133 | Fresenius Medical Care Nw Indiana, LLC | Clinic/Center | 1330 W. Wisconsin St., Hobart, IN 46342 | 2012-11-06 |
| 1356600548 | Accurate Home Health Inc | Home Health | 8792 E. Ridge Road, Suite A, Hobart, IN 46342 | 2012-05-09 |
| 1164728051 | Lynn Rentz | Mechanotherapist | 103 E.third St., Suite 1, Hobart, IN 46342 | 2011-02-10 |
| 1720214208 | Felipe Isip Chua Jr. | Physician Assistant | 101 West 61st Avenue, Hobart, IN 46342 | 2009-06-10 |
| 1326289067 | Sheila Anne Flynn | Registered Nurse | 101 W. 61st Ave., Hobart, IN 46342 | 2009-03-10 |
| 1194941021 | Arc Bridges, Inc | Custodial Care Facility | 3583 Randolph Drive, Hobart, IN 46342 | 2007-04-18 |
| 1164542940 | Felix Rosel Gozo Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1354 S Lake Park Avenue, St Marys Spectrum Rehab Center Cardiac, Hobart, IN 46342 | 2007-03-29 |
| 1003932666 | Major Hospital | Skilled Nursing Facility | 4410 W 49th Ave, Hobart, IN 46342 | 2007-03-22 |
| 1295884682 | Marie Jean Mercado Hedges | Physical Therapist | 4530 16th St., Hobart, IN 46342 | 2007-01-09 |
| Find all providers in zip 46342 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568810422 | Scal of Hobart, LLC | Assisted Living Facility | 650 Centennial Centre Blvd, Hobart, WI 54155-8989 | 2016-06-01 |
| 1083094726 | Gahc3 Hobart In Alf Trs Sub, LLC | Assisted Living Facility | 1420 Saint Marys Cir, Hobart, IN 46342-6561 | 2015-06-08 |
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| 1821615444 | Newburgh Assisted Living, LLC | Assisted Living Facility | 4211 Grimm Rd, Newburgh, IN 47630-9444 | 2020-06-30 |
| 1003431461 | Residential Care Xiii L.L.C. | Assisted Living Facility | 741 Park East Blvd, Lafayette, IN 47905-0797 | 2020-06-11 |
| 1902429822 | Hellenic Senior Living of Mishawaka LLC | Assisted Living Facility | 1540 S. Logan Street, Mishawaka, IN 46544 | 2020-05-27 |
| 1659994200 | Lake Meadows Licensee LLC | Assisted Living Facility | 11570 E 126th Street, Fishers, IN 46037 | 2020-05-18 |
| 1730712886 | Cook Road Aal Lp | Assisted Living Facility | 3731 W Cook Rd, Fort Wayne, IN 46818-9403 | 2020-02-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.