OrganizationActive
Sober Living in Madison, LLC
NPI 1013633882 · Substance Use Disorder Rehabilitation Clinic/Center · Madison, WI
Provider details
- NPI number
- 1013633882
- Entity type
- Organization
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Mirzo Khasimov, President(608) 520-7142
Specialties & taxonomies
Ambulatory Health Care Facilities
- Clinical Medical Laboratory291U00000X
Laboratories
- Substance Abuse Rehabilitation Facility324500000X
Residential Treatment Facilities
Practice location
2101 N Sherman Ave
Madison, WI 53704-3932
Phone: (608) 520-7142
Approximate (ZIP-level) locationGet directions
Mailing address
2101 N Sherman Ave
Madison, WI 53704-3932
Registry dates
- Enumerated
- 2022-10-13
- Last updated
- 2022-10-14
- Certified
- 2022-10-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.