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General NPI Number Information
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NPI Number | 1669847174
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Entity Type | Organization
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Legal Business Name | SOBRIETY BRINGS A CHANGE
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Dates
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Enumeration Date | 12/09/2015
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Last Update Date | 08/06/2020
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Provider Practice Location Address
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Address Line | 810 V ST RM 2
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City | SACRAMENTO
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State | CA
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Zip | 95818-1330
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Country | US
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Telephone | 916-264-4700
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Fax | 916-264-4701
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Provider Business Mailing Address
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Address Line | 4600 47TH AVE STE 102
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City | SACRAMENTO
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State | CA
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Zip | 95824-3923
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Country | US
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Telephone | 916-454-4242
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. SANDRA G HILL
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Credential | BA
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Telephone | 916-454-4242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 340008AN
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License Number State | CA
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