Provider Demographics
NPI:1154283851
Name:LIVING STONE SOBER LIVING, LLC
Entity type:Organization
Organization Name:LIVING STONE SOBER LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:SUD
Authorized Official - Phone:209-406-7633
Mailing Address - Street 1:227 E DOWNS ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-2005
Mailing Address - Country:US
Mailing Address - Phone:209-406-7633
Mailing Address - Fax:209-406-7633
Practice Address - Street 1:227 E DOWNS ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-2005
Practice Address - Country:US
Practice Address - Phone:209-406-7633
Practice Address - Fax:209-406-7633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-01
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty