Organization
IMMANUEL SOBRIETY INC.
Active
Other names
Immanuel House
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH REID (EXECUTIVE DIRECTOR)
(951) 530-7680
Entity
Organization
Contact information
Practice address
14340 ELSWORTH ST # 108&109, MORENO VALLEY, CA 92553-9019
(951) 653-3000
Mailing address
PO BOX 10271, MORENO VALLEY, CA 92552-0271
(951) 653-3000
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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