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A Sober Way Home

Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) in Prescott, AZ. Organization (NPI-2).

NPI number1982894036
StatusActive
Last updated in NPPESFeb 9, 2017

Details

NPI
1982894036
Entity type
Organization (NPI-2)
Legal business name
A Sober Way Home
Organization subpart
No
Enumeration date
Jul 25, 2007
Last updated
Feb 9, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)BH3230AZYes
276400000X Rehabilitation, Substance Use Disorder UnitBH3230AZ
261QR0800X Clinic/Center, Recovery CareBH2563AZ

Practice location

1211 East Gurley Street
Suite 2
Prescott, AZ 86301

Phone 928-445-3834 · Fax 928-445-3649

Mailing address

1211 East Gurley Street
Suite 2
Prescott, AZ 86301

Phone 928-445-3834 · Fax 928-445-3649

Authorized official

Sandra Tillman
President
9284453834

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