Provider Demographics
NPI:1215480413
Name:STANLEY SOBER LIVING
Entity type:Organization
Organization Name:STANLEY SOBER LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:E
Authorized Official - Last Name:OPALAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-570-1260
Mailing Address - Street 1:725 N STANLEY AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-7425
Mailing Address - Country:US
Mailing Address - Phone:561-570-1260
Mailing Address - Fax:561-570-1266
Practice Address - Street 1:725 N STANLEY AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-7425
Practice Address - Country:US
Practice Address - Phone:561-570-1260
Practice Address - Fax:561-570-1266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility