Summit Estate Recovery Centers LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

440017AP Issued in CA

Legal business name

SUMMIT ESTATE RECOVERY CENTERS LLC

Doing business as

Summit Estate
Summit Estate Recovery Center

Practice address

4145 Old Adobe Rd
Palo Alto, CA 94306-3724

Phone

(800) 701-6997

Fax

(323) 576-5345

NPI assigned

Oct 6, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Sergei Vidov

Title

Ceo

Phone

(310) 498-3626

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 4

• Summit Estate Doing business as
• Summit Estate Recovery Center Doing business as
• Summit Estate Inc Former legal business name
• Summit Estate Outpatient Other name

Tax ID family

Summit Estate Recovery Centers LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Summit Estate Recovery Centers LLC

  • Substance Abuse Rehabilitation Facility
  • San Jose, CA
  • NPI 1750263810
  NPD tax ID
• Summit Estate Recovery Centers LLC

  • Substance Abuse Rehabilitation Facility
  • San Bruno, CA
  • NPI 1790667848
  NPD tax ID

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Summit Estate Recovery Centers LLC

  • Substance Abuse Rehabilitation Facility
  • San Jose, CA
  • NPI 1750263810
  NPPES parent name
• Summit Estate Recovery Centers LLC

  • Substance Abuse Rehabilitation Facility
  • San Bruno, CA
  • NPI 1790667848
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1679857775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7280 BLUE HILL DR STE 7",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951293624",
            "telephone_number": "800-701-6997",
            "fax_number": "323-576-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4145 OLD ADOBE RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943063724",
            "telephone_number": "800-701-6997",
            "fax_number": "323-576-5345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14455 Pike Rd",
            "address_purpose": "LOCATION",
            "city": "Saratoga",
            "state": "CA",
            "postal_code": "950705385",
            "country_code": "US",
            "telephone_number": "408-353-5352",
            "fax_number": "323-576-5345",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7280 Blue Hill Dr Ste 7",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951293624",
            "country_code": "US",
            "telephone_number": "800-701-6997",
            "fax_number": "323-576-5345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUMMIT ESTATE RECOVERY CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-06",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "VIDOV",
        "authorized_official_first_name": "SERGEI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-498-3626",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "440017AP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHCS",
            "identifier": "430100AP",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHCS",
            "identifier": "430077CP",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Estate",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Summit Estate Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Summit Estate Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Summit Estate Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Summit Estate Outpatient",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nancy Elizabeth Sullivan, PH.D.
• Pervez Sultan, MD
• Mina Sultana, DDS
• Lirio Sumera
• Eyrica Naomi Sumida
• Eric Tyler Sumner, DO
• Caroline H Sun
• Kristin Anne Sun, MD
• Qisi Sun, MD
• Vivien Kon-Ea Sun, MD

• Substance Abuse Rehabilitation Facility in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.