Organization
SOBER PARTNERS WATERFRONT RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT RAFFA (CEO)
(949) 201-5192
Entity
Organization
Contact information
Practice address
1001 W 17TH ST STE A, COSTA MESA, CA 92627-4512
(949) 201-5192
Mailing address
1001 W 17TH ST STE A, COSTA MESA, CA 92627-4512
(949) 201-5192
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
200205BP
CA
Other
Enumeration date
05/24/2016
Last updated
05/03/2019
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