Organization
B. RILEY SOBER HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAFAEL ANTONIO CORREA (FOUNDER)
(216) 417-4831
Entity
Organization
Contact information
Practice address
2121 W 117TH ST, CLEVELAND, OH 44111-1642
(216) 417-4831
Mailing address
2121 W 117TH ST, CLEVELAND, OH 44111-1642
(216) 417-4831
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0454981
—
OH
Enumeration date
09/02/2021
Last updated
05/16/2023
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