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General NPI Number Information
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NPI Number | 1831990241
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Entity Type | Organization
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Legal Business Name | ACTION SOBER LIVING
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Dates
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Enumeration Date | 03/21/2025
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 5149 CAVANAGH RD
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City | LOS ANGELES
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State | CA
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Zip | 90032-4005
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Country | US
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Telephone | 213-606-5674
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Fax |
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Provider Business Mailing Address
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Address Line | 46 PENINSULA CTR UNIT 465
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City | ROLLING HILLS ESTATES
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State | CA
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Zip | 90274-3558
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Country | US
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Telephone | 323-528-5674
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RAYMOND WRAY
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Credential |
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Telephone | 323-528-5674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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