| Organization Name: | CLEAN AND SOBER |
| NPI Number: | 1629127816 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FRITZ LINDROTH SCHMIDT (EXECUTIVE DIRECTOR) |
| Mailing Address: | 7610 Pennsylvania Ave Suite 104 Forestville |
| State: | MD US |
| Postal Code: | 207474701 |
| Phone Number: | 3014204663 |
| Fax Number: | 3014203492 |
| NPI Enumeration Date: | 01/09/2007 |
| NPI Last Update Date: | 09/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 15662 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |