Provider Demographics
NPI:1578088209
Name:SOBRIETY 1ST CREW RECOVERY LLC
Entity Type:Organization
Organization Name:SOBRIETY 1ST CREW RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:STEFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-630-6771
Mailing Address - Street 1:2121 S BLACKHAWK ST STE 200S
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1490
Mailing Address - Country:US
Mailing Address - Phone:720-476-3074
Mailing Address - Fax:
Practice Address - Street 1:2121 S BLACKHAWK ST STE 200S
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1490
Practice Address - Country:US
Practice Address - Phone:720-476-3074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1843-00101YA0400X, 261QM0850X, 261QR0405X, 324500000X
363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty