MEDICARE: STONE & SAGE SOBER LIVING 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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1194689281
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STONE & SAGE SOBER LIVING INC

Provider Business Mailing Address
First Line	:	412 NW 57TH ST
Second Line	:
City	:	LAWTON
State	:	OK
Zip	:	73505-5715
Country	:	US
Telephone Number	:	714-951-2257
Fax Number	:

Provider Business Practice Location Address
First Line	:	1415 NW 22ND ST
Second Line	:
City	:	LAWTON
State	:	OK
Zip	:	73505-3901
Country	:	US
Telephone Number	:	714-951-2257
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	BRITTANY QUICK
Credential	:
Telephone Number	:	714-951-2257

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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Directions to “STONE & SAGE SOBER LIVING INC ” Practice Location

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