Organization
SOBER MOUNTAIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMMON D MANGUM (OWNER/ PARTNER)
(928) 551-6099
Entity
Organization
Contact information
Practice address
580 E OLD LINDEN RD STE 3, SHOW LOW, AZ 85901-4817
(928) 551-6099
Mailing address
580 E OLD LINDEN RD STE 7, SHOW LOW, AZ 85901-4817
(928) 551-6099
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
12/01/2022
Last updated
01/19/2026
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