Provider Demographics
NPI:1164222527
Name:OUT AND SOBER OHIO
Entity type:Organization
Organization Name:OUT AND SOBER OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-400-2325
Mailing Address - Street 1:1045 WALTON AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-5336
Mailing Address - Country:US
Mailing Address - Phone:937-400-2325
Mailing Address - Fax:
Practice Address - Street 1:1045 WALTON AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-5336
Practice Address - Country:US
Practice Address - Phone:937-400-2325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAVING LIVES OHIO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-15
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty