Provider Demographics
NPI:1558809723
Name:HIGH SOBRIETY, LLC
Entity Type:Organization
Organization Name:HIGH SOBRIETY, LLC
Other - Org Name:HIGH SOBRIETY
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRANK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-433-7013
Mailing Address - Street 1:1801 CENTURY PARK E
Mailing Address - Street 2:SUITE 470
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8740 VENICE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-3225
Practice Address - Country:US
Practice Address - Phone:800-515-3909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility