Organization
CLEAN SLATE SOBER LIVING
Active
Organization
CLEAN SLATE SOBER LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEILAND WOODS (COO)
(404) 782-2988
Entity
Organization
Contact information
Practice address
714 E MAIN ST, TROTWOOD, OH 45426-2909
(844) 548-7627
Mailing address
714 E MAIN ST, TROTWOOD, OH 45426-2909
(844) 548-7627
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103TC1900X
Counseling Psychologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
11/25/2018
Last updated
12/12/2019
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