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SOBA MESA LLC
NPI 1144670951
Substance Abuse Rehabilitation Facility in Mesa, AZ

Active since June 13, 2016CLIA Certified · 2 labs
6262 E BROADWAY RD STE 110, MESA, AZ 85206(480) 664-4053 Get Directions Write a Review

NPPES record last updated: June 9, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 9, 2026, Jun 3, 2025, Feb 1, 2023 and 1 more (4 updates tracked since 2016).

About Soba Mesa Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOBA MESA LLC (NPI 1144670951), doing business as Soba Recovery Center, is a healthcare organization registered as a substance abuse rehabilitation facility in Mesa, Arizona and active in the NPI registry since June 2016. The organization holds 2 active CLIA laboratory certificates and lists Audrey Graham, Cfo, as its authorized official.

NPPES Registry Identity

NPI1144670951
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameSOBA MESA LLC
Location Address6262 E BROADWAY RD STE 110Mesa, AZ 85206-6101
Mailing Address6262 E Broadway Rd Ste 110Mesa, AZ 85206-6101 · (480) 664-4053
Phone(480) 664-4053
Organization SubpartNo
Authorized OfficialAudrey GrahamCfo · (310) 457-5250
Enumeration DateJune 13, 2016
Last NPPES UpdateJune 9, 20264 updates tracked since enumeration
NPPES CertifiedJune 9, 2026
✔ NPI 1144670951 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

Also ListedClinic/Center · Mental Health (Including Community Mental Health Center)Taxonomy 261QM0801X
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X · License OTC6989 (AZ)
6262 E BROADWAY RD STE 110, Mesa, AZ 85206
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Other Names 1

Doing Business AsSoba Recovery Center

Other Identifiers 1

Other03D2084103AZ · Clia

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2084103

Soba Mesa LLC - Broadway · Mesa, AZ
Active · expires Sep 17, 2026
CLIA Number03D2084103
Laboratory TypeTreatment Facility
Certificate Effective DateSeptember 18, 2024
Certificate Expiration DateSeptember 17, 2026
Laboratory DirectorJennifer N. Ohara
Laboratory Phone(310) 457-5250
Laboratory LocationSoba Mesa LLC - Broadway6262 E Broadway Rd, Ste 110, Mesa, AZ 85206
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 03D2110429

Soba Mesa LLC Dba Soba Recovery Center · Mesa, AZ
Active · expires Mar 14, 2028
CLIA Number03D2110429
Laboratory TypeAddiction Treatment
Certificate Effective DateMarch 15, 2026
Certificate Expiration DateMarch 14, 2028
Laboratory DirectorReyes R. Topete
Laboratory Phone(480) 664-4053
Laboratory LocationSoba Mesa LLC Dba Soba Recovery Center6215 E Arbor Ave, Mesa, AZ 85206
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERIK ADAIR JOHNSON
Counselor
6262 E BROADWAY RD STE 110
MESA, AZ 85206
Maricopa County (480) 664-4058
KIMBERLY LAUREN GREENWOOD LISAC
Counselor (Addiction (Substance Use Disorder))
6262 E BROADWAY RD STE 110
MESA, AZ 85206
Maricopa County (480) 210-5570

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Soba Mesa LLC's NPI number?

The NPI number for Soba Mesa LLC is 1144670951. It was assigned to this organization in the NPPES registry on June 13, 2016. The provider is doing business as Soba Recovery Center.

Where is Soba Mesa LLC located?

Soba Mesa LLC is located at 6262 E Broadway Rd Ste 110, Mesa, AZ 85206. The listed phone number is (480) 664-4053.

What is Soba Mesa LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Soba Mesa LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Soba Mesa LLC accept?

Health plans from Blue Cross Blue Shield of Arizona list Soba Mesa LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Soba Mesa LLC was last updated on June 9, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.