MEDICARE: STANLEY SOBER LIVING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1215480413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STANLEY SOBER LIVING

Provider Business Mailing Address
First Line	:	725 N STANLEY AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90046-7425
Country	:	US
Telephone Number	:	561-570-1260
Fax Number	:	561-570-1266

Provider Business Practice Location Address
First Line	:	725 N STANLEY AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90046-7425
Country	:	US
Telephone Number	:	561-570-1260
Fax Number	:	561-570-1266

Authorized Official
Title or Position	:	CONSULTANT
Name	:	ANGELA E OPALAK
Credential	:
Telephone Number	:	561-570-1260

Provider Enumeration Date	:	07/25/2016
Last Update Date	:	07/25/2016

Similar Medicare Providers

1558295287 — HOLLYWOOD ACCEPTANCE LLC
Practice Location Address:

725 N STANLEY AVE
LOS ANGELES, CA
90046-7425

Practice Phone: 323-481-3312
Practice Fax:

1376757989 — DEPARTMENT OF HEALTH SERVICES
Practice Location Address:

7425 RANCHO LOS GUILICOS RD
SANTA ROSA, CA
95409-6519

Practice Phone: 707-565-4700
Practice Fax:

1609063098 — DIANA E ANTONIO
Practice Location Address:

7425 RANCHO LOS GUILICOS RD , DEPT A
SANTA ROSA, CA
95409-6519

Practice Phone: 707-537-6387
Practice Fax:

1275715955 — MS. COLLEEN M LEWIS MFT, ATR
Practice Location Address:

7425 RANCHO LOS GUILICOS RD DEPT B
SANTA ROSA, CA
95409-6530

Practice Phone: 707-495-7388
Practice Fax:

1992961767 — KELLYE SUSAN BRASSEL
Practice Location Address:

7425 RANCHO LOS GUILICOS RD
SANTA ROSA, CA
95409-6519

Practice Phone: 707-565-6387
Practice Fax:

1669605374 — MAYRA PEREZ LOPEZ
Practice Location Address:

7425 RANCHO LOS GUILICOS RD
SANTA ROSA, CA
95409-6519

Practice Phone: 707-565-6318
Practice Fax:

Directions to “STANLEY SOBER LIVING ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.