SOBER SHORES, INCORPORATED (NPI# 1528200961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528200961 |
| Entity Type | Organization |
| Organization Name | SOBER SHORES, INCORPORATED |
| Practice Address |
42509 Carino Pl Temecula CA 92592-2239 |
| Practice Telephone | 8666605763 |
| Practice Fax Number | 9515262264 |
| Mailing Telephone | 8666605763 |
| Mailing Fax Number | 9515262264 |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2009-03-31 |
| Authorized Official Name | MR. SEAN REAGAN STAFFORD SR. (DIRECTOR) |
| Authorized Official Telephone | 8666605763 |
| Authorized Official Credential | J.D., CAS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 330084AP | CA | Residential Treatment Facilities |
| Street Address |
42509 CARINO PL |
| City | TEMECULA |
| State | CA |
| Zip Code | 92592-2239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366051625 | Huey Q Tran, Dds, Inc. | Dentist | 33321 Temecula Parkway Ste 104, Temecula, CA 92592 | 2020-07-23 |
| 1902425465 | Isak Elkayam | Student in an Organized Health Care Education/Training Program | 31700 Temecula Parkway, Parkway Suites # 2- Gme, Temecula, CA 92592 | 2020-04-14 |
| 1033738737 | Jordan Buckley | Student in an Organized Health Care Education/Training Program | Uhs Socal Medical Education Consortium, 31700 Temecula Parkway Parkway Suites # 2- Gme, Temecula, CA 92592 | 2020-04-13 |
| 1366071052 | Areg Hovsepyan | Internal Medicine | 31700 Temecula Parkway Parkway Suites # 2- Gme, Temecula, CA 92592 | 2020-04-03 |
| 1558906982 | Session Sync, Inc. | Point of Service | 44262 Marcelina Court, Temecula, CA 92592 | 2019-11-08 |
| 1962964718 | Krishna Theja Reddy Venkatamuni Reddy | Student in an Organized Health Care Education/Training Program | Uhs Socal Medical Education Consortium, 31700 Temecula Parkway, Parkway Suites # 2- Gme, Temecula, CA 92592 | 2019-04-02 |
| 1598220246 | Shanay Lamont Moore | Behavior Technician | 30660 Milky Way Dr., V174, Temecula, CA 92592 | 2019-02-07 |
| 1477029502 | Tibbitts Temecula Dental Group | Clinic/Center | 32909 Temecula Parkway Ste 102, Temecula, CA 92592 | 2018-10-16 |
| 1720563364 | Nicole Louise Hernandez | Behavioral Analyst | 32144 Camino Nunez, Temecula, CA 92592 | 2018-09-29 |
| 1174010664 | Kiet Chau | Pharmacist | 32228 Highway 79 South, Temecula, CA 92592 | 2018-04-19 |
| Find all providers in zip 92592 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700410958 | Ranch Creek Recovery,inc. | Substance Abuse Rehabilitation Facility | 43264 Business Park Dr Ste 101, Temecula, CA 92590-3646 | 2020-02-26 |
| 1538654520 | Rancho Milagro Recovery Inc | Substance Abuse Rehabilitation Facility | 37235 Painted Pony Rd, Temecula, CA 92592-8221 | 2018-06-22 |
| 1609389162 | Southern California Addiction Center | Substance Abuse Rehabilitation Facility | 44764 Mumm St, Temecula, CA 92592-5546 | 2017-11-07 |
| 1538672084 | Southern California Addiction Center | Substance Abuse Rehabilitation Facility | 40624 Calle Cancion, Temecula, CA 92592-9472 | 2017-11-07 |
| 1174971493 | Inland Detox, Inc. | Substance Abuse Rehabilitation Facility | 38630 Mesa Rd, Temecula, CA 92592-8631 | 2016-05-26 |
| 1346614666 | Southern California Addiction Center | Substance Abuse Rehabilitation Facility | 36500 De Portola Rd, Temecula, CA 92592-7801 | 2015-11-24 |
| 1265818082 | Best New Life Recovery | Substance Abuse Rehabilitation Facility | 20755 Carancho Rd, Temecula, CA 92590-4242 | 2015-08-04 |
| 1770967267 | Second2none | Substance Abuse Rehabilitation Facility | 32619 Via Perales, Temecula, CA 92592-8148 | 2015-07-14 |
| 1124408166 | 2 Shine Again, Inc | Substance Abuse Rehabilitation Facility | 37347 Avednida Chapala, Temecula, CA 92592 | 2015-06-04 |
| 1437496833 | Dave Leo Johnson | Substance Abuse Rehabilitation Facility | 42012 Dahlia Way, Temecula, CA 92591-5356 | 2013-01-07 |
| Find all providers in TEMECULA | ||||
Please comment or provide details below to improve the information on SOBER SHORES, INCORPORATED.
| 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.