Sober Living Outpatient LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SOBER LIVING OUTPATIENT LLC

Practice address

416 S. E. 5TH Street
Delray Beach, FL 33483-4442

Phone

(877) 659-4555

NPI assigned

Jul 10, 2012

Last updated

Jul 15, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Kolker, MSW

Title

Therapist/Owner

Phone

(877) 659-4555

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405382400000",
    "number": "1154686731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 S. E. 5TH STREET",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334834442",
            "telephone_number": "877-659-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 S. E. 5TH STREET",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334834442",
            "telephone_number": "877-659-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOBER LIVING OUTPATIENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-10",
        "last_updated": "2014-07-15",
        "status": "A",
        "authorized_official_last_name": "KOLKER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "877-659-4555",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; 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.