Organization
SUMMIT SENIOR LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD ZIEBART (MANAGER)
(503) 363-4636
Entity
Organization
Contact information
Practice address
5524 W 6200 S, KEARNS, UT 84118-7925
(801) 520-3391
Mailing address
201 NE PARK PLAZA DR STE 105, VANCOUVER, WA 98684-5874
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
2016ALIIUT000744
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5524
—
UT
Enumeration date
07/13/2016
Last updated
07/13/2016
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