SOBER MOUNTAIN LLC
NPI 1356051122
Clinic/Center - Rehabilitation in Show Low, AZ
About Sober Mountain Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOBER MOUNTAIN LLC (NPI 1356051122) is a healthcare organization registered as a rehabilitation in Show Low, Arizona and active in the NPI registry since December 2022. The organization holds a CLIA Waiver certificate valid through March 6, 2027 and lists Ammon D Mangum, Owner/ Partner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
CLIA Laboratory Certificates CMS CLIA
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 03D2319792
Sober Mountain · Show Low, AZFrequently 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 Sober Mountain LLC's NPI number?
The NPI number for Sober Mountain LLC is 1356051122. It was assigned to this organization in the NPPES registry on December 1, 2022.
Where is Sober Mountain LLC located?
Sober Mountain LLC is located at 580 E Old Linden Rd Ste 3, Show Low, AZ 85901. The listed phone number is (928) 551-6099.
What is Sober Mountain LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, with taxonomy code 261QR0400X.
Does Sober Mountain LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 03D2319792) is associated with this NPI, valid through March 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Sober Mountain LLC accept?
Health plans from Blue Cross Blue Shield of Arizona list Sober Mountain 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 Sober Mountain LLC was last updated on January 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Sober Mountain Llc · NPI 1356051122
Rehabilitation organization in Show Low, Arizona. Organization record, active in the CMS NPPES registry since December 1, 2022.
## Identity
- **NPI:** 1356051122 (Entity type: Organization)
- **Enumerated:** December 1, 2022
- **Primary specialty:** Clinic/Center - Rehabilitation · taxonomy 261QR0400X
- **Organization subpart:** No
- **Authorized official:** Ammon Mangum, OWNER/ PARTNER
## Practice location
- **Address:** 580 E OLD LINDEN RD STE 3, Show Low, AZ 85901-4817
- **Phone:** (928) 551-6099
## Record status
- **NPPES last updated:** January 19, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1356051122) · Data from the CMS NPPES public registry.