SUMMIT ESTATE RECOVERY CENTERS LLC
NPI 1679857775
Substance Abuse Rehabilitation Facility in Palo Alto, CA

NPI Status: Active since October 06, 2011

Contact Information

4145 OLD ADOBE RD
PALO ALTO, CA
ZIP 94306
Phone: (800) 701-6997
Fax: (323) 576-5345

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  • Organization
  • Substance Abuse Rehabilitation Facility
  • CLIA Number: 05D2147156
  • CLIA Cert. Type: Other - ADDICTION TREATMENT CTR
  • CLIA Exp. Date: 04-12-2026

About SUMMIT ESTATE RECOVERY CENTERS LLC

This page provides the complete NPI Profile along with additional information for Summit Estate Recovery Centers Llc, a provider established in Palo Alto, California operating as a Substance Abuse Rehabilitation Facility. The healthcare provider is registered in the NPI registry with number 1679857775 assigned on October 2011. The practitioner's primary taxonomy code is 324500000X with license number 440017AP (CA). The provider is registered as an organization and their NPI record was last updated one year ago. The provider's . The authorized official of this NPI record is Mr. Sergei Vidov (Ceo)

NPI
1679857775
Provider Legal Name
SUMMIT ESTATE RECOVERY CENTERS LLC
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
4145 OLD ADOBE RD PALO ALTO, CA 94306
Location Phone
(800) 701-6997
Location Fax
(323) 576-5345
Mailing Address
7280 BLUE HILL DR STE 7 SAN JOSE, CA 95129
Mailing Phone
(800) 701-6997
Mailing Fax
(323) 576-5345
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-06-2011
Last Update Date
05-28-2025
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Location Map

Secondary Locations

  • 14455 Pike Rd
    Saratoga, CA 95070
    (408) 353-5352
  • 7280 Blue Hill Dr Ste 7
    San Jose, CA 95129
    (800) 701-6997

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Substance Abuse Rehabilitation Facility

Taxonomy Code
324500000X
Type
Residential Treatment Facilities
License No.
440017AP
License State
CA
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1261QM0801XAmbulatory Health Care Facilities

Clinic/Center
Mental Health (Including Community Mental Health Center)

 
2261QM0850XAmbulatory Health Care Facilities

Clinic/Center
Adult Mental Health

 
3261QR0405XAmbulatory Health Care Facilities

Clinic/Center
Rehabilitation, Substance Use Disorder

 
4276400000XHospital Units

Rehabilitation, Substance Use Disorder Unit

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. SERGEI VIDOV

Authorized Official Title
CEO
Authorized Official Phone
(310) 498-3626

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
430100APOTHER (01)CADHCS
430077CPOTHER (01)CADHCS

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D2147156
Facility Type
Other - ADDICTION TREATMENT CTR
Certificate Effective Date
April 13, 2024
Certificate Expiration Date
April 12, 2026
Laboratory Director
LISA M. BENYA
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Summit Estate Recovery Centers Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1679857775, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 75. The final step is to find the difference between that total and the next multiple of ten (80 - 75 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
9
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
5
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
7
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 8 → 16 → 7 7 → 14 → 5 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 4 + 9 + 1 + 6 + 5 + 1 + 4 + 7 + 1 + 4 + 24 = 75

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 75 is 80. The difference is the calculated check digit.

80 - 75 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1679857775.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Social Worker (Clinical)
4145 OLD ADOBE RD
PALO ALTO, CA 94306

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1679857775, enumerated as an "organization" on October 06, 2011.

The provider is located at 4145 OLD ADOBE RD PALO ALTO, CA 94306 and the phone number is (800) 701-6997.

Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.