Clean & Sober Recovery Services Inc.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

CLEAN & SOBER RECOVERY SERVICES INC.

Doing business as

Clean & Sober Recovery Home

Practice address

9198 Greenback LN
Suite 101
Orangevale, CA 95662-5900

Phone

(916) 990-0190

Fax

(916) 990-0193

NPI assigned

Dec 2, 2016

Last updated

Dec 2, 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

Mr. John Perry, CADC-CAS

Title

President

Phone

(916) 990-0190

Specialties & licenses 1

Addresses

Other names 1

• Clean & Sober Recovery Home Doing business as

Tax ID family

Clean Sober Recovery Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Clean & Sober Recovery Services Inc.

  dba Clean & Sober Recovery Home Inc.

  • Substance Abuse Rehabilitation Facility
  • Orangevale, CA
  • NPI 1528227840
  NPD tax ID

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

{
    "created_epoch": "1480636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480636800000",
    "number": "1922541317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9198 GREENBACK LN",
            "address_2": "SUITE 101",
            "city": "ORANGEVALE",
            "state": "CA",
            "postal_code": "956625900",
            "telephone_number": "916-990-0190",
            "fax_number": "916-990-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9198 GREENBACK LN",
            "address_2": "SUITE 101",
            "city": "ORANGEVALE",
            "state": "CA",
            "postal_code": "956625900",
            "telephone_number": "916-990-0190",
            "fax_number": "916-990-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAN & SOBER RECOVERY SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-02",
        "last_updated": "2016-12-02",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-990-0190",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CADC-CAS"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clean & Sober Recovery Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Giselle Centeno
• Center for Positive Changes
• Dawtanya Chandler
• Eberechi Chindah Lynch, LVN
• Clean & Sober Recovery Services Inc. (Clean & Sober Recovery Home Inc.)
• Brett Stephen Coder, LMFT
• Erica Casey Collins, OTR/L
• Community Birth Group
• Keyoni-Emma Conley
• Taylor Paige Console

• Substance Use Disorder Rehabilitation Clinic/Center in Orangevale, CA
• Providers in Orangevale, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.