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NPI Code Detail

MEDICARE: SOBRIETY HOUSE, INC.

MEDICARE: SOBRIETY HOUSE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation Facility1072-02CO
2261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center1072-02CO

General Provider Information

NPI Number : 1083617344
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOBRIETY HOUSE, INC.
Provider Business Mailing Address
First Line : 107 ACOMA ST
Second Line :
City : DENVER
State : CO
Zip : 80223-1429
Country : US
Telephone Number : 303-722-5746
Fax Number : 303-777-7601
Provider Business Practice Location Address
First Line : 107 ACOMA ST
Second Line :
City : DENVER
State : CO
Zip : 80223-1429
Country : US
Telephone Number : 303-722-5746
Fax Number : 303-777-7601
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. WILLIAM ANDREW DOLAN
Credential : LCSW CACIII
Telephone Number : 303-722-5746
Provider Enumeration Date : 05/31/2005
Last Update Date : 11/05/2020

Similar Medicare Providers

1659501013 — MR. ROBERT L NELSON JR. CACIII
Practice Location Address:
107 ACOMA ST
DENVER, CO
80223-1429
Practice Phone: 303-722-5746
Practice Fax: 303-777-7601
1821228990 — MS. LAUREL ELSA WEINGARTEN BS, CACIII
Practice Location Address:
107 ACOMA ST
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80223-1429
Practice Phone: 303-722-5746
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1841420072 — MR. WILLIAM ANDREW DOLAN MSW LCSW CACIII
Practice Location Address:
107 ACOMA ST
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Practice Fax:
1538409362 — SOBRIETY HOUSE, INC.
Practice Location Address:
121 W. 1ST AVE.
DENVER, CO
80223-1429
Practice Phone: 303-722-5746
Practice Fax:
1467792242 — SOBRIETY HOUSE, INC.
Practice Location Address:
121 ACOMA ST
DENVER, CO
80223-1429
Practice Phone: 720-381-4332
Practice Fax:
1528309929 — CRYSTAL AHLES LCSW, LAC
Practice Location Address:
121 ACOMA ST
DENVER, CO
80223-1429
Practice Phone: 303-722-5746
Practice Fax:

Directions to “SOBRIETY HOUSE, INC. ” Practice Location

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