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Organization

SUMMIT SUPPORT LIVING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ELIYAHU GOLDSTEIN (DIRECTOR OF OPERATIONS)
(248) 662-7849
Entity
Organization

Contact information

Practice address
8170 MCCORMICK BLVD STE 123, SKOKIE, IL 60076-2961
(248) 662-7849
Mailing address
8170 MCCORMICK BLVD STE 123, SKOKIE, IL 60076-2961
(248) 662-7849

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
08/11/2025
Last updated
08/11/2025
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