Organization
SANCTUARY SOBER LIVING LLC
Active
Parent organization
SANCTUARY SOBER LIVING LLC
Other names
SRC Cave Creek
Organization subpart
Yes
Provider details
NPI number
Legal business name
SANCTUARY SOBER LIVING LLC
Authorized official
JOSEPH LANDIN III (ADMINISTRATOR)
(480) 309-9945
Entity
Organization
Contact information
Practice address
11645 N CAVE CREEK RD, PHOENIX, AZ 85020-1300
(602) 612-3816
Mailing address
PO BOX 9952, PHOENIX, AZ 85068-0952
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
—
—
106S00000X
Behavior Technician
—
—
171100000X
Acupuncturist
—
—
174200000X
Meals Provider
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085186
—
AZ
Enumeration date
07/06/2021
Last updated
08/15/2025
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