NPIMap

Organization Active NPI

Sanctuary Sober Living LLC

Doing business as SRC Cave Creek

  • Community/Behavioral Health Agency
  • Phoenix, AZ
National Provider Identifier
1629649132
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SANCTUARY SOBER LIVING LLC
Doing business as
SRC Cave Creek
Practice address
10828 N Cave Creek Rd
Phoenix, AZ 85020-1406
Phone
(602) 612-3816
Fax
(480) 281-5225
NPI assigned
Jul 6, 2021
Organization subpart
Yes
Parent organization
SANCTUARY SOBER LIVING LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Authorized official

Name
Joseph Glenn Landin III
Title
Chief Executive Officer
Phone
(480) 309-9945

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Meals Provider 174200000X
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary
In Home Supportive Care Agency 253Z00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Non-emergency Medical Transport (VAN) 343900000X

Addresses

Primary practice location

10828 N Cave Creek Rd
Phoenix, AZ 85020-1406

Mailing address

PO Box 9952
Phoenix, AZ 85068-0952
Phone (844) 978-8783

Other identifiers 1

IdentifierTypeStateIssuer
106281MedicaidAZ

Other names 1

  • SRC Cave Creek Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sanctuary Sober Living LLC6 organizations share this tax ID, including this one
Part of
Sanctuary Sober Living LLC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1340 E Desert Cove Ave
Phoenix, AZ 85020
Phone (480) 477-7899

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788480000000",
    "number": "1629649132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9952",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850680952",
            "telephone_number": "844-978-8783",
            "fax_number": "480-281-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10828 N CAVE CREEK RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850201406",
            "telephone_number": "602-612-3816",
            "fax_number": "480-281-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANCTUARY SOBER LIVING LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SANCTUARY SOBER LIVING LLC",
        "enumeration_date": "2021-07-06",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A",
        "authorized_official_last_name": "LANDIN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "480-309-9945",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106281",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SRC Cave Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; 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.