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General NPI Number Information
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NPI Number | 1639359086
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Entity Type | Organization
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Legal Business Name | SOBRIETY SERVICES, INC.
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 31877 DEL OBISPO ST SUITE 104
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-3233
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Country | US
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Telephone | 949-273-4200
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Fax | 949-489-1189
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Provider Business Mailing Address
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Address Line | 31877 DEL OBISPO ST SUITE 105
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-3233
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Country | US
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Telephone | 949-273-4200
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Fax | 949-488-0447
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Authorized Official
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Title or Position | CEO
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Name | MR. DENNIS LARKIN
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Credential | CATC
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Telephone | 949-273-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 30077AP
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License Number State | CA
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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 | 300177AP
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License Number State | CA
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