Clean Adventures of Sober Living, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

OTC6727 Issued in AZ

Legal business name

CLEAN ADVENTURES OF SOBER LIVING, LLC

Practice address

534 Madison Ave
Prescott, AZ 86301-2433

Phone

(928) 443-8767

Fax

(928) 776-4781

NPI assigned

Feb 22, 2010

Last updated

Apr 21, 2016By 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

Robert Carson Patton

Title

Owner/Executive Director

Phone

(928) 443-8767

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1266796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461196800000",
    "number": "1366764045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 MADISON AVE",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863012433",
            "telephone_number": "928-443-8767",
            "fax_number": "928-776-4781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 MADISON AVE",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863012433",
            "telephone_number": "928-443-8767",
            "fax_number": "928-776-4781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAN ADVENTURES OF SOBER LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-22",
        "last_updated": "2016-04-21",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "CARSON",
        "authorized_official_title_or_position": "OWNER/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "928-443-8767"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH-3525",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "OTC6727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Clark
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• Kathleen Carey Clarkin-Dedio, DC
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• Sarah Beth Claussen, FNP-C
• Clear Choice Leasing (New Era Hearing)
• Lisa Simone Cleary, LCSW
• Eric F Cleland, PT
• Marybeth Cleland, RN
• Roxanne Clever, LMSW

• Community/Behavioral Health Agency in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; 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.