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General NPI Number Information
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NPI Number | 1083586523
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Entity Type | Organization
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Legal Business Name | SOBER LIFE RECOVERY SOLUTIONS LLC
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 8619 JACKIE DR
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City | SAN DIEGO
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State | CA
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Zip | 92119-1414
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Country | US
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Telephone | 619-542-9542
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Fax | 619-566-4979
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Provider Business Mailing Address
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Address Line | 3930 4TH AVE STE 300
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City | SAN DIEGO
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State | CA
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Zip | 92103-3119
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Country | US
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Telephone | 619-542-9542
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Fax | 619-566-4979
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Authorized Official
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Title or Position | CEO
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Name | DEOMEL SORIANO
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Credential | PMHNP
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Telephone | 619-542-9542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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