A Sober Way Home
Organization Active NPI Comprehensive Outpatient Rehabilitation Facility (CORF) · Prescott, AZ
NPI 1982894036 · NPPES record last updated Feb 9, 2017
Key facts
- NPI
- 1982894036
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X
- License
- BH3230 (AZ)
- Legal business name
- A SOBER WAY HOME
- Practice address
- 1211 East Gurley Street
Suite 2
Prescott, AZ 86301 - Phone
- (928) 445-3834
- Fax
- (928) 445-3649
- NPI assigned
- Jul 25, 2007
- Organization subpart
- No
Authorized official
- Name
- Sandra Tillman
- Title
- President
- Phone
- (928) 445-3834
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- A Sober Way Home
Locations
1211 E Gurley St
Ste 2
Prescott, AZ 86301
Phone (928) 445-3834
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Comprehensive Outpatient Rehabilitation Facility (CORF) | 261QR0401X | BH3230 | AZ | Yes |
| Recovery Care Clinic/Center | 261QR0800X | BH2563 | AZ | |
| Substance Use Disorder Rehabilitation Hospital Unit | 276400000X | BH3230 | AZ |
Addresses
Primary practice location
1211 East Gurley Street
Suite 2
Prescott, AZ 86301
Mailing address
1211 East Gurley Street
Suite 2
Prescott, AZ 86301
Phone (928) 445-3834
Other providers in Prescott, AZ
- 1918 Winter Street Operating Co LLC
- 1918 Winter Street Operating Co LLC
- A Sober Way Home
- A2A Hearing Health, LLC
- ABA Supportive Care Az LLC
- Kamani Ngozi Abarikwu
- Delmas Lee Abbott
- Ability Two, LLC
All providers in Prescott, AZ · Comprehensive Outpatient Rehabilitation Facility (CORF) in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.