Provider Demographics
NPI:1245637362
Name:GOD'S PROPERTY SOBER LIVING FOUNDATION
Entity type:Organization
Organization Name:GOD'S PROPERTY SOBER LIVING FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:DERRICK
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-420-7345
Mailing Address - Street 1:1704 W MANCHESTER AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90047-3063
Mailing Address - Country:US
Mailing Address - Phone:323-305-1538
Mailing Address - Fax:323-305-1776
Practice Address - Street 1:1704 W MANCHESTER AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90047-3063
Practice Address - Country:US
Practice Address - Phone:323-305-1538
Practice Address - Fax:323-305-1776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-04
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Single Specialty