Organization
SOBER LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE C. HAINES (OWNER)
(336) 988-9715
Entity
Organization
Contact information
Practice address
208 CLOVERBROOK DR, JAMESTOWN, NC 27282-9616
(336) 988-9715
Mailing address
208 CLOVERBROOK DR, JAMESTOWN, NC 27282-9616
(336) 988-9175
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/16/2024
Last updated
04/16/2024
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