NPI: 1336599182
Provider Name: SOBA TEXAS LLC
Doing Business As: SOBA RECOVERY CENTER
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization
Specialization: Rehabilitation, Substance Use Disorder
CLIA Number: 45D2213400
Address:
1401 DEZARAE, LOT 4
SAN ANTONIO, TX
ZIP 78253
Phone: (210) 530-4167
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SOBA TEXAS LLC is a rehabilitation and substance use disorder clinic center in San Antonio, TX. SOBA TEXAS LLC NPI is 1336599182. The provider is registered as an organization entity type.
The provider Is Doing Business As Soba Recovery Center.
The provider's business location address is:
1401 DEZARAE, LOT 4
SAN ANTONIO, TX
ZIP 78253
Phone: (210) 530-4167
The provider's authorized official is Audrey Graham .
The authorized official title is Cfo and has the following contact phone number (310) 457-5250.
The CLIA number assigned to this NPI record is 45D2213400 - other - treatment center with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 6/13/2016 and was last updated on 3/28/2022.