Soba Mesa LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SOBA MESA LLC

Practice address

6262 E Broadway Rd Ste 110
Mesa, AZ 85206-6101

Phone

(480) 664-4053

NPI assigned

Jun 13, 2016

Organization subpart

No

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

Authorized official

Name

Audrey Graham

Title

Cfo

Phone

(310) 457-5250

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Soba Recovery Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Soba Mesa LLC2 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.

• Soba Mesa LLC

  • Psychiatric Hospital
  • Mesa, AZ
  • NPI 1326491283
  NPD tax ID

Locations

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780963200000",
    "number": "1144670951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6262 E BROADWAY RD STE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852066101",
            "telephone_number": "480-664-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6262 E BROADWAY RD STE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852066101",
            "telephone_number": "480-664-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOBA MESA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-13",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "310-457-5250"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "AZ",
            "license": "OTC6989",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "03D2084103",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Soba Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Crystianne Snyder
• Kellie Snyder
• Madison Snyder
• Joann So
• Raina So, LMFT
• Soba Mesa LLC
• Jerelyn Soberanes
• Amir Sobhi, D.M.D
• Stephanie Soderblom, L.M.
• Tayler Soefje

• Substance Abuse Rehabilitation Facility in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Substance Abuse Rehabilitation Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.