SOBER LIFE RECOVERY SOLUTIONS LLC


Address: 1446 Front St Ste 400, San Diego, CA 92101-3425
Phone: 6195429542

SOBER LIFE RECOVERY SOLUTIONS LLC (NPI# 1386148625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1386148625
Entity Type Organization
Organization Name SOBER LIFE RECOVERY SOLUTIONS LLC
Practice Address 1446 Front St Ste 400
San Diego
CA 92101-3425
Practice Telephone 6195429542
Mailing Telephone 6195429542
Enumeration Date 2018-03-21
Last Update Date 2019-01-14
Authorized Official Name DR. JOHN MICHAEL EVOSEVICH (CEO)
Authorized Official Telephone 6195429542
Authorized Official Credential PHD, LMFT, CADC,
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0405X Clinic/Center
Specialization: Rehabilitation, Substance Use Disorder
CA Ambulatory Health Care Facilities

Office Location

Street Address 1446 FRONT ST STE 400
City SAN DIEGO
State CA
Zip Code 92101-3425

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1487172516 Jessica Roach Counselor 1045 9th Avenue, San Diego, CA 92101 2017-09-09
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1356882245 Dajah Mone't Lockett Counselor 2535 Kettner Blvd Suite 1a4, San Diego, CA 92101 2017-03-13
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Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

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1497230429 Ethridge Recovery Center Clinic/Center 405 63rd St, San Diego, CA 92114-4237 2018-09-25
1023595519 Holistix Treatment Centers LLC Clinic/Center 6310 Alvarado Ct, San Diego, CA 92120-4902 2018-07-26
1124539960 Crash, Inc. Clinic/Center 835 25th St, San Diego, CA 92102-2738 2017-10-19
1538611165 The Betty Ford Center At San Diego Clinic/Center 11720 El Camino Real, Suite 200, San Diego, CA 92130-2224 2016-10-31
1730552084 San Diego Student Recovery, LLC Clinic/Center 5440 Morehouse Dr Ste 4500, San Diego, CA 92121-6724 2015-11-09
1841699352 Community Behavioral Health Solutions, Inc Clinic/Center 7071 Consolidated Way, San Diego, CA 92121 2014-08-20
1700989829 San Diego Health Alliance Clinic/Center 7545 Metropolitan Dr, San Diego, CA 92108-4402 2006-09-06
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Competitor

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City SAN DIEGO
Zip Code 92101

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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