Provider Demographics
NPI:1023980539
Name:SUMMIT RECOVERY CENTER
Entity type:Organization
Organization Name:SUMMIT RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:VEST
Authorized Official - Suffix:
Authorized Official - Credentials:CADCII, QMHA, CRM
Authorized Official - Phone:971-710-5408
Mailing Address - Street 1:6828 SE HOLGATE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-3504
Mailing Address - Country:US
Mailing Address - Phone:503-841-1127
Mailing Address - Fax:
Practice Address - Street 1:6828 SE HOLGATE BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-3504
Practice Address - Country:US
Practice Address - Phone:503-841-1127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility