Organization
PGN OP SUMMIT LLC
Active
Other names
Summit's Trace Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL GOLDNER (AUTHORIZED OFFICIAL)
(732) 645-9800
Entity
Organization
Contact information
Practice address
935 N CASSADY AVE, COLUMBUS, OH 43219-2283
(614) 252-4987
Mailing address
525 CHESTNUT ST STE 102, CEDARHURST, NY 11516-2223
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
09/04/2020
Last updated
09/04/2020
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