Provider Demographics
NPI:1124475975
Name:SOBER BEGINNINGS TREATMENT CENTER, LLC
Entity type:Organization
Organization Name:SOBER BEGINNINGS TREATMENT CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMHC
Authorized Official - Phone:954-304-5699
Mailing Address - Street 1:6944 COLUMBIA CT
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-8006
Mailing Address - Country:US
Mailing Address - Phone:954-304-5699
Mailing Address - Fax:954-372-2069
Practice Address - Street 1:1145 BANKS RD
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-6702
Practice Address - Country:US
Practice Address - Phone:305-814-7623
Practice Address - Fax:954-372-2069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder