Src Cave Creek

LBN: Sanctuary Sober Living Llc
Src Cave Creek is an health care organization with primary practice located at 11645 N Cave Creek Rd , Phoenix AZ 85020-1300. The organization recently has 10 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Behavior Technician, Other Service Providers / Meals, Agencies / Case Management, Agencies / Community/Behavioral Health, Agencies / In Home Supportive Care, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Adult Mental Health, Transportation Services / Non-emergency Medical Transport (VAN). Agencies / Community/Behavioral Health is the primary health care specialty. Sanctuary Sober Living Llc can be contacted via phone (602) 612-3816, or through Landin, Joseph via phone (480) 309-9945.

Contact Information

Primary practice address
11645 N Cave Creek Rd Phoenix AZ 85020-1300
Phone: (602) 612-3816
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Landin, Joseph
Phone: (480) 309-9945

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Social Worker 104100000X
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Other Service Providers / Meals 174200000X
Agencies / Case Management 251B00000X
Agencies / Community/Behavioral Health 251S00000X
Agencies / In Home Supportive Care 253Z00000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X
Transportation Services / Non-emergency Medical Transport (VAN) 343900000X

Profile Details

NPI number 1629649132
LBN Legal business name Sanctuary Sober Living Llc
DBA Doing business as Src Cave Creek
Authorized official Landin, Joseph
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 6th, 2021
Last updated Feb 13th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629649132 NPPES
Arizona MEDICAID 085186

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