Soba Living LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

190664AP Issued in CA

Legal business name

SOBA LIVING LLC

Doing business as

Malibu Recovery Center

Practice address

22677 Pacific Coast Hwy
Malibu, CA 90265-5036

Phone

(866) 547-6451

Fax

(310) 919-3667

NPI assigned

Jun 10, 2009

Organization subpart

No

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

Authorized official

Name

Michelle Johns

Title

Account Executive

Phone

(310) 457-2730

Specialties & licenses 1

Addresses

Other names 1

• Malibu Recovery Center Doing business as

Locations

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467244800000",
    "number": "1437385937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23440 CIVIC CENTER WAY",
            "address_2": "SUITE 102",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902655901",
            "telephone_number": "866-547-6451",
            "fax_number": "310-919-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22677 PACIFIC COAST HWY",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902655036",
            "telephone_number": "866-547-6451",
            "fax_number": "310-919-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOBA LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-10",
        "last_updated": "2016-06-30",
        "status": "A",
        "authorized_official_last_name": "JOHNS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "ACCOUNT EXECUTIVE",
        "authorized_official_telephone_number": "310-457-2730"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190664AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Malibu Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sleepmax
• Craig V Smith, M.D.
• Nakia Danielle Smith, MASSAGE THERAPIST
• Kristine Alice Smylie, MA, MA, MFT
• Katherine Sniffen, ATC
• Soba Outpatient and Recovery LLC (Soar)
• Socal Psych, Inc
• Socal Recovery Centers, Inc. (Malibu Life Recovery Center)
• Shahram Soroudi, PHARMD
• William David Stanley, MD

• Substance Abuse Rehabilitation Facility in Malibu, CA
• Providers in Malibu, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.