SUMMIT ON PENINSULA
NPI 1174188239
Substance Abuse Rehabilitation Facility in San Jose, CA

Q: What is Synthesis Recovery LLC's NPI number?

The NPI number for Synthesis Recovery LLC is 1174188239. It was assigned to this organization in the NPPES registry on May 4, 2019. The provider is doing business as Summit On Peninsula, Summit Peninsula and Summit on the Peninsula.

Q: What is Synthesis Recovery LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Active since May 04, 2019

5498 BLACKOAK WAY, SAN JOSE, CA 95129(833) 338-1373 Get Directions Write a Review

NPPES record last updated: May 22, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 22, 2019, May 4, 2019 (2 updates tracked since 2019).

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About Summit On Peninsula NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUMMIT ON PENINSULA (NPI 1174188239) is a healthcare organization registered as a substance abuse rehabilitation facility in San Jose, California and active in the NPI registry since May 2019. The organization lists Sergei Vidov, Ceo, as its authorized official.

NPPES Registry Identity

NPI1174188239

Entity TypeOrganization

Primary Taxonomy324500000X

Legal Business NameSYNTHESIS RECOVERY LLC

Location Address5498 BLACKOAK WAYSan Jose, CA 95129-3110

Mailing Address2238 Kirsten Lee DrWestlake Village, CA 91361-5564 · (310) 498-3626

Phone(833) 338-1373

Organization SubpartNo

Authorized OfficialSergei VidovCeo · (310) 498-3626

Enumeration DateMay 4, 2019

Last NPPES UpdateMay 22, 20192 updates tracked since enumeration

✔ NPI 1174188239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities

Taxonomy Code324500000X

Definition

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

5498 BLACKOAK WAY, San Jose, CA 95129

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Other Names 3

Doing Business AsSummit On Peninsula

Doing Business AsSummit Peninsula

Doing Business AsSummit On The Peninsula

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Synthesis Recovery LLC's NPI number?

The NPI number for Synthesis Recovery LLC is 1174188239. It was assigned to this organization in the NPPES registry on May 4, 2019. The provider is doing business as Summit On Peninsula, Summit Peninsula and Summit on the Peninsula.

Where is Synthesis Recovery LLC located?

Synthesis Recovery LLC is located at 5498 Blackoak Way, San Jose, CA 95129. The listed phone number is (833) 338-1373.

What is Synthesis Recovery LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

When was this NPI record last updated?

The NPPES record for Synthesis Recovery LLC was last updated on May 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.