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General NPI Number Information
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NPI Number | 1801262076
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Entity Type | Organization
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Legal Business Name | THE SOBER LINING
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Dates
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Enumeration Date | 08/11/2015
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Last Update Date | 06/02/2016
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Provider Practice Location Address
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Address Line | 2312 PARK AVE SUITE 139
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City | TUSTIN
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State | CA
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Zip | 92782-2702
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Country | US
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Telephone | 800-939-4237
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Fax |
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Provider Business Mailing Address
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Address Line | 2312 PARK AVE SUITE 139
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City | TUSTIN
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State | CA
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Zip | 92782-2702
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Country | US
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Telephone | 800-939-4237
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Fax |
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Authorized Official
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Title or Position | ASSISTANT
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Name | MS. HEATHER WILLIAMS
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Credential |
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Telephone | 800-939-4237
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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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