Summit Intensive Outpatient Program

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

SUMMIT INTENSIVE OUTPATIENT PROGRAM

Practice address

21115 Vanowen St # 110
Canoga Park, CA 91303-2849

Phone

(888) 885-6648

NPI assigned

Jan 27, 2026

Organization subpart

No

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

Authorized official

Name

Vyacheslav Davtian

Title

Ceo

Phone

(888) 885-6648

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1769472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789084800000",
    "number": "1851240378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21115 VANOWEN ST # 110",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913032849",
            "telephone_number": "888-885-6648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21115 VANOWEN ST # 110",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913032849",
            "telephone_number": "888-885-6648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT INTENSIVE OUTPATIENT PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-27",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A",
        "authorized_official_last_name": "DAVTIAN",
        "authorized_official_first_name": "VYACHESLAV",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "888-885-6648"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Canoga Park, CA
• Providers in Canoga Park, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; 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.