Organization
SUMMIT SKILLED NURSING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHADENE HARRY STOBY (OWNER/ PRESIDENT)
(860) 994-9448
Entity
Organization
Contact information
Practice address
107 MONTICELLO AVE, SPRINGFIELD, MA 01109-1413
(860) 994-9448
Mailing address
107 MONTICELLO AVE, SPRINGFIELD, MA 01109-1413
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
10/03/2025
Last updated
10/03/2025
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