Organization
PHOENIX SOBRIETY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SACHEL JOY ELLIOTT (ADMINISTRATION/OFFICER)
(484) 378-6789
Entity
Organization
Contact information
Practice address
1711 LIBERTY BELL WAY APT 3, LOUISVILLE, KY 40215-1671
(502) 593-6380
Mailing address
1711 LIBERTY BELL WAY APT 3, LOUISVILLE, KY 40215-1671
(502) 593-6380
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
02/23/2024
Last updated
02/24/2024
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