Provider Demographics
NPI:1437684198
Name:SOBERDASH LLC
Entity Type:Organization
Organization Name:SOBERDASH LLC
Other - Org Name:SOBER DASHBOARD
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JD
Authorized Official - Middle Name:
Authorized Official - Last Name:MEINTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-274-6376
Mailing Address - Street 1:4232 LAS VIRGENES RD
Mailing Address - Street 2:STE B
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-3589
Mailing Address - Country:US
Mailing Address - Phone:877-884-6917
Mailing Address - Fax:
Practice Address - Street 1:4232 LAS VIRGENES RD
Practice Address - Street 2:STE B
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-3589
Practice Address - Country:US
Practice Address - Phone:877-884-6917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility