Provider Demographics
NPI:1467615625
Name:SIGNS OF SOBRIETY
Entity Type:Organization
Organization Name:SIGNS OF SOBRIETY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SHEVLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:609-882-7677
Mailing Address - Street 1:100 SCOTCH RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-2507
Mailing Address - Country:US
Mailing Address - Phone:609-882-7677
Mailing Address - Fax:609-882-6808
Practice Address - Street 1:100 SCOTCH RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628-2507
Practice Address - Country:US
Practice Address - Phone:609-882-7677
Practice Address - Fax:609-882-6808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2000009-04261QR0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care