Provider Demographics
NPI:1831567940
Name:SOBER FLOW RECOVERY PROJECT LLC
Entity type:Organization
Organization Name:SOBER FLOW RECOVERY PROJECT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JIANDAN
Authorized Official - Middle Name:JANET
Authorized Official - Last Name:PAYZA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, BC-DMT
Authorized Official - Phone:818-207-0870
Mailing Address - Street 1:10315 WOODLEY AVE STE 229
Mailing Address - Street 2:DEVONWOOD OFFICE PARK
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-6951
Mailing Address - Country:US
Mailing Address - Phone:818-207-0870
Mailing Address - Fax:
Practice Address - Street 1:10315 WOODLEY AVE STE 229
Practice Address - Street 2:DEVONWOOD OFFICE PARK
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-6951
Practice Address - Country:US
Practice Address - Phone:818-207-0870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-04
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0662261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder