Soba Outpatient and Recovery LLC

NPI #1477983393 in Malibu, California

Provider Information

NPI Number: 1477983393
Entity Type: Organization
Organization Name: Soba Outpatient and Recovery LLC
Subpart: Yes (part of a larger organization)
Parent Organization: SOBA OUTPATIENT AND RECOVERY
Primary Specialty: Community/Behavioral Health
Enumeration Date: Nov 13, 2013
Last Updated: Nov 13, 2013

Practice Location

Address: 22814 PACIFIC COAST HWY
City: Malibu
State: California
ZIP Code: 90265-5041
Phone: (310) 310-7740

Authorized Official

Name: MR. GREGORY PAUL HANNLEY, RRW
Title: OWNER
Phone: (310) 924-2053

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community/Behavioral Health	251S00000X	Primary

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