Provider Demographics
NPI:1538706775
Name:SOBERMAN'S ESTATE LLC
Entity Type:Organization
Organization Name:SOBERMAN'S ESTATE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MITCH
Authorized Official - Middle Name:
Authorized Official - Last Name:PRAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-295-8013
Mailing Address - Street 1:100 EASY ST UNIT 5167
Mailing Address - Street 2:
Mailing Address - City:CAREFREE
Mailing Address - State:AZ
Mailing Address - Zip Code:85377-7116
Mailing Address - Country:US
Mailing Address - Phone:602-295-8013
Mailing Address - Fax:833-969-0106
Practice Address - Street 1:3010 E CLOUD RD
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-5621
Practice Address - Country:US
Practice Address - Phone:602-295-8013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-06
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder