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General NPI Number Information
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NPI Number | 1659218444
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Entity Type | Organization
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Legal Business Name | SUMMIT SOBER LIVING INC.
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Dates
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Enumeration Date | 04/30/2026
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 851 IRWIN ST STE 302
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City | SAN RAFAEL
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State | CA
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Zip | 94901-3343
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Country | US
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Telephone | 415-686-5783
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Fax |
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Provider Business Mailing Address
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Address Line | 8 CREEKSIDE CT
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City | NOVATO
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State | CA
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Zip | 94945-2150
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Country | US
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Telephone | 415-686-5783
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL TRIOLO
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Credential | CADC-CAS
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Telephone | 415-686-5783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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