Sober District Inc

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

SOBER DISTRICT INC

Practice address

6628 Van Nuys Blvd
Van Nuys, CA 91405-4617

Phone

(213) 364-8065

NPI assigned

Mar 31, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tigran Mamikonyan

Title

Ceo

Phone

(818) 859-3568

Specialties & licenses 1

Addresses

Tax ID family

Sober District Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sober District Inc

  • Substance Abuse Rehabilitation Facility
  • Sherman Oaks, CA
  • NPI 1699316265
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540944000000",
    "number": "1023514957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6628 VAN NUYS BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6628 VAN NUYS BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054617",
            "telephone_number": "213-364-8065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOBER DISTRICT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-31",
        "last_updated": "2018-10-31",
        "status": "A",
        "authorized_official_last_name": "MAMIKONYAN",
        "authorized_official_first_name": "TIGRAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-859-3568"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.