Organization
SOBA CHEVIOT HILLS LLC
Active
Other names
CLUB SOBA
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE JOHNS (ACCOUNT EXECUTIVE)
(310) 457-2730
Entity
Organization
Contact information
Practice address
3384 MOTOR AVE, LOS ANGELES, CA 90034-3712
(310) 457-2730
(310) 919-0319
Mailing address
3384 MOTOR AVE, LOS ANGELES, CA 90034-3712
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
190822AP
CA
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
05/13/2014
Last updated
07/29/2016
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