Organization
SOBER SPACE
Active
Other names
Vern Johnson
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VERN JOHNSON (OWNER)
(602) 524-0583
Entity
Organization
Contact information
Practice address
2501 W ELM ST, 10, PHOENIX, AZ 85017-3627
(602) 524-0583
Mailing address
PO BOX 44701, PHOENIX, AZ 85064-4701
(602) 524-0583
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/21/2014
Last updated
05/21/2014
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