Organization
SANCTUARY SOBER LIVING LLC
Active
Parent organization
46400604
Other names
SRC Desert Cove
Organization subpart
Yes
Provider details
NPI number
Legal business name
46400604
Authorized official
JOSEPH LANDIN (CEO)
(602) 612-3816
Entity
Organization
Contact information
Practice address
1340 E DESERT COVE AVE, PHOENIX, AZ 85020-1110
(602) 612-3816
Mailing address
11645 N CAVE CREEK RD, PHOENIX, AZ 85020-1300
(602) 612-3816
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
07/12/2023
Last updated
07/12/2023
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