Provider Demographics
NPI:1790332344
Name:SOBRIETY SUPPORT SOLUTIONS
Entity Type:Organization
Organization Name:SOBRIETY SUPPORT SOLUTIONS
Other - Org Name:THE HOUSE OF RISING SON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-238-1038
Mailing Address - Street 1:34145 PACIFIC COAST HWY # 800
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2808
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:147 EL LEVANTE
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-3138
Practice Address - Country:US
Practice Address - Phone:603-966-8389
Practice Address - Fax:949-606-8518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-19
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health