Provider Demographics
NPI:1831990241
Name:ACTION SOBER LIVING
Entity type:Organization
Organization Name:ACTION SOBER LIVING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:WRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-528-5674
Mailing Address - Street 1:46 PENINSULA CTR UNIT 465
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3558
Mailing Address - Country:US
Mailing Address - Phone:323-528-5674
Mailing Address - Fax:
Practice Address - Street 1:5149 CAVANAGH RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90032-4005
Practice Address - Country:US
Practice Address - Phone:213-606-5674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACTION INVESTMENT DEVELOPMENT INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging