Provider Demographics
NPI:1548893316
Name:SOBER HOMIEZ SERVICES LLC
Entity type:Organization
Organization Name:SOBER HOMIEZ SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING MANAGER/MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:725-261-4369
Mailing Address - Street 1:4566 S PECOS RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5923
Mailing Address - Country:US
Mailing Address - Phone:725-261-4369
Mailing Address - Fax:702-898-8530
Practice Address - Street 1:4566 S PECOS RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5923
Practice Address - Country:US
Practice Address - Phone:725-261-4369
Practice Address - Fax:702-898-8530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251K00000XAgenciesPublic Health or Welfare
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No251E00000XAgenciesHome Health
No251V00000XAgenciesVoluntary or Charitable