Provider Demographics
NPI:1538473814
Name:SOBRIETY FIRST, LLC
Entity Type:Organization
Organization Name:SOBRIETY FIRST, LLC
Other - Org Name:RECOVERY FIRST TREATMENT CENTER, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:GLATZMAIER
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:320-251-0035
Mailing Address - Street 1:3333 W. DIVISION STREET
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301
Mailing Address - Country:US
Mailing Address - Phone:320-251-0035
Mailing Address - Fax:320-251-0209
Practice Address - Street 1:3333 W. DIVISION ST.
Practice Address - Street 2:SUITE 210
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301
Practice Address - Country:US
Practice Address - Phone:320-251-0035
Practice Address - Fax:320-251-0209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1056586-1-CDT261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder