Soberlife Recovery Incorporated

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Legal business name

SOBERLIFE RECOVERY INCORPORATED

Practice address

11604 E 23Rd Street
Tulsa, OK 74129

Phone

(918) 630-6029

NPI assigned

Jul 31, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Travis Leon Anderson

Title

Cfo

Phone

(918) 630-6029

Specialties & licenses 2

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brent Chad Hardrick

  • Peer Specialist
  • Tulsa, OK
  • NPI 1598593238
  NPD
• Michael Cris Pennington

  • Peer Specialist
  • Tulsa, OK
  • NPI 1194597773
  NPD

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1407685134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11604 E 23RD STREET",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74129",
            "telephone_number": "918-630-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11604 E 23RD STREET",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74129",
            "telephone_number": "918-630-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOBERLIFE RECOVERY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "918-630-6029",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Snyder, APRN
• Tamara R Snyder, C.N.P
• Taylor Snyder, DO
• Soaak Clinics LLC
• Josiah J Soap, CRNA
• Anna Christine Sobol, RD
• Remington Malle Soderling, D.O.
• Tyler Soderling, DO
• Leetta Delores Sodiya
• Jonathan Chu-Ming Soetandio, DMD

• Peer Specialist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.