Organization
SOBER LIFE COACH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROMAN BRALY CADC II (COUNSELLOR)
(619) 674-3501
Entity
Organization
Contact information
Practice address
6757 FRIARS RD UNIT 14, SAN DIEGO, CA 92108-5013
(619) 674-3501
Mailing address
6757 FRIARS RD UNIT 14, SAN DIEGO, CA 92108-5013
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
A042941116
CA
171M00000X
Case Manager/Care Coordinator
A042941116
CA
251B00000X
Case Management Agency
Primary
A042941116
CA
Other
Enumeration date
10/29/2017
Last updated
10/29/2017
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