# SOBER LIFE COACH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780196972
- **Authorized official:** ROMAN BRALY CADC II (COUNSELLOR)
- **Authorized official phone:** (619) 674-3501

## Contact information

- **Practice address:** 6757 FRIARS RD UNIT 14, SAN DIEGO, CA 92108-5013
- **Practice address phone:** (619) 674-3501
- **Mailing address:** 6757 FRIARS RD UNIT 14, SAN DIEGO, CA 92108-5013

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | A042941116 | CA | — |
| 171M00000X | Case Manager/Care Coordinator | A042941116 | CA | — |
| 251B00000X | Case Management Agency | A042941116 | CA | Yes |

## Other

- **Enumeration date:** 10/29/2017
- **Last updated:** 10/29/2017