Organization
CLEAN ADVENTURES OF SOBER LIVING, LLC
Active
Organization
CLEAN ADVENTURES OF SOBER LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT CARSON PATTON (OWNER/EXECUTIVE DIRECTOR)
(928) 443-8767
Entity
Organization
Contact information
Practice address
534 MADISON AVE, PRESCOTT, AZ 86301-2433
(928) 443-8767
(928) 776-4781
Mailing address
534 MADISON AVE, PRESCOTT, AZ 86301-2433
(928) 443-8767
(928) 776-4781
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
BH-3525
AZ
251S00000X
Community/Behavioral Health Agency
Primary
OTC6727
AZ
Other
Enumeration date
02/22/2010
Last updated
04/21/2016
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