The NARR levels of care are four tiers of recovery housing defined by the National Alliance for Recovery Residences, running from Level 1 peer-run homes with no paid staff to Level 4 clinically integrated residences. Each level describes how much structure, staffing, and clinical service a residence provides, not how good it is.
The four levels are Level 1 (Type P, peer-run), Level 2 (Type M, monitored), Level 3 (Type S, supervised), and Level 4 (Type C, clinical). As of August 2026 the governing document is the NARR National Standard 3.0, released in November 2018 and applied locally by 33 state affiliate organizations.
Most independently owned sober living homes in the United States operate at Level 2. This guide explains what each level requires, which level a new operator should choose, and how the level you pick changes your staffing, your certification path, and your referral relationships.
Choosing a level is one of the first real decisions a recovery housing operator makes, and it drives almost everything that follows: whether you need paid staff, whether the state gets involved, which referral sources will work with you, and what your monthly operating budget looks like. Getting it wrong is expensive. Understanding the four NARR levels of care before you open is how you avoid that.
What Are the NARR Levels of Care?
The NARR levels of care are a classification system that sorts recovery residences by how much support they provide. The National Alliance for Recovery Residences (NARR) publishes the standard; independent state affiliates certify individual homes against it. NARR itself does not certify homes.
Two things about the levels are widely misunderstood, and both matter for operators.
The levels are not a quality ranking. A Level 4 residence is not better than a Level 1 residence. The levels describe intensity of service, and the right level depends entirely on where a resident is in recovery. A well-run Level 2 home serves someone leaving inpatient treatment far better than a clinical program they no longer need.
The levels carry letter types as well as numbers. NARR’s Standard 3.0 pairs each level with a type letter: Level I Type P, Level II Type M, Level III Type S, and Level IV Type C. Affiliates and state agencies use both notations, sometimes in the same document, so an operator should recognize either.
Every document a carrier asks for, and the wording that gets applications kicked back.
The Four NARR Levels at a Glance
| Level | Who Runs It | Defining Feature |
|---|---|---|
| Level 1 Type P · Peer-Run |
The residents themselves, democratically | No paid staff and no owner-operator on site. Oxford Houses are the best-known example. |
| Level 2 Type M · Monitored |
An owner or operator, for-profit or nonprofit | House rules and peer accountability, with a House Mentor or senior resident on site. No clinical services. |
| Level 3 Type S · Supervised |
An organization with paid staff | Weekly structured programming and life-skills development delivered by staff, plus administrative oversight. |
| Level 4 Type C · Clinical |
A licensed treatment provider | Clinical and social models combined, with credentialed clinical staff and licensed services on site. |
Watch: The NARR Levels of Sober Living Explained
Level 1: Peer-Run Recovery Residences (Type P)
A NARR Level 1 recovery residence is a democratically run, alcohol- and drug-free home with no paid staff, where residents govern themselves, set house policy by vote, and hold one another accountable. It is the least intensive of the four levels and the least expensive to run, because there is no payroll at all.
Residents divide the practical work of the house between them: collecting rent, running weekly business meetings, assigning chores, voting on who moves in, and voting on who has to leave. Outside oversight is minimal by design. Oxford Houses are the most widely recognized Level 1 model, and NARR names them directly in its own description of the level.
Level 1 suits residents who already have stability in recovery and want low cost and high autonomy rather than structure. For an operator, the trade-off is control: a genuine Level 1 house is not one you manage, and if you are placing a House Mentor or setting the rules yourself, you are running a Level 2 home whatever you call it.
Level 2: Monitored Recovery Residences (Type M)
A NARR Level 2 recovery residence is an owner-operated, alcohol- and drug-free home that uses written house rules and peer accountability to keep the environment safe, with a House Mentor or senior resident on site to hold the standard. Level 2 is where the large majority of independently owned sober living homes in the United States sit, and it is the level almost every new operator should be building toward.
The structure is heavier than Level 1 but stops well short of clinical care. A Level 2 home typically runs on documented house rules every resident signs at intake, regular drug and alcohol testing, a requirement to attend mutual-aid meetings or outpatient services, and a House Mentor who lives in the home and handles day-to-day accountability. Residents work, attend school, or engage treatment on their own; the house does not provide the treatment.
This is also the level people are describing when they use the older informal terms. A “three-quarter house,” a “3/4 house,” or a “monitored sober home” almost always means a Level 2 recovery residence under the NARR standard.
Level 2 suits residents stepping down from inpatient treatment or a Level 3 program who still need accountability but are ready for independence. For operators, it is the level with the clearest economics: no clinical licensure, no professional payroll, and a certification path that a first-time operator can realistically complete.
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Level 3: Supervised Recovery Residences (Type S)
A NARR Level 3 recovery residence delivers weekly structured programming, including peer-based and other recovery support services, through paid staff and an administrative organization behind the house. Level 3 is the first level where the residence itself is providing services rather than simply requiring residents to get them elsewhere.
In practice that means an organizational chart, not just a House Mentor. A Level 3 home typically employs a facility manager and certified staff, writes an individual service plan for each resident, runs life-skills development on a schedule, and documents resident progress. Staffing turns the residence into an employer, which brings payroll, supervision, credentialing, and insurance obligations a Level 2 operator does not carry.
Recovery residence certification and state licensure are two different things, and the line between them moves at Level 3 and Level 4. Certification is granted by the NARR affiliate in your state and is voluntary in most states. Licensure is granted by a state agency and applies once a residence delivers clinical or treatment services. Confirm both with your own state before you commit to a level.
State treatment of Level 3 varies more than most operators expect, and secondhand advice on this point is frequently wrong. Massachusetts is a useful example precisely because it is often misdescribed: the state does not license sober homes at any NARR level. Certification through the Massachusetts Alliance for Sober Housing is voluntary. What the Massachusetts law does, under Chapter 165, Section 37 of the Acts of 2014, is bar state agencies and their statewide-contract vendors from referring anyone to a sober home that is not certified. The practical effect is that certification is optional on paper and close to mandatory for anyone who wants state referrals.
Level 4: Clinical Recovery Residences (Type C)
A NARR Level 4 recovery residence integrates the social and clinical models, using a combination of supervised peer support and credentialed professional staff to deliver treatment inside the residence. Level 4 homes, sometimes still called service provider residences, are the most intensive of the four levels and are almost always operated by a licensed treatment provider under state license.
A Level 4 residence looks less like a house with rules and more like a treatment program with beds. Clinical staff, which can include physicians, licensed therapists, and addiction counselors, are on site. Residents receive group and individual therapy and clinical case management as part of the residence, and medication management is handled within the program.
Level 4 suits residents who need clinical support alongside housing, typically people recently discharged from detox or moving directly out of inpatient treatment. It is not a level an independent operator enters from a standing start. Opening a Level 4 residence means becoming a licensed treatment provider first, with the clinical leadership, licensure, and capital that implies.
Medication is not what puts a home at Level 4. A residence where residents take their own prescribed medication stays at the level its staffing and services set, and a MAT policy for a sober living home shows how a non-clinical home can support residents on MAT.
Keep reading Where Does Sober Living Fit in the Continuum of Care? How recovery housing connects treatment, transition, and independent living. →Compare the Four NARR Levels Side by Side
The differences that matter most to an operator are not in the definitions but in the operating requirements. The table below sets the four levels against the requirements that actually decide which one you can run.
| Requirement | Level 1 Type P · Peer-Run |
Level 2 Type M · Monitored |
Level 3 Type S · Supervised |
Level 4 Type C · Clinical |
|---|---|---|---|---|
| In one sentence | A democratically run recovery home with no paid staff, where residents set policy and hold each other accountable by vote. | An owner-operated recovery home using written house rules and peer accountability, with a House Mentor or senior resident on site. | A recovery residence delivering weekly structured programming and life-skills development through paid staff, with an administrative organization behind it. | A residence integrating the social and clinical models, combining supervised peer support with credentialed professional staff delivering treatment on site. |
| Staffing | None. No paid staff and no manager on site. | A House Mentor or senior resident on site. No clinical staff. | Paid facility manager and certified staff. An organizational chart, not one mentor. | Credentialed clinical staff, which can include physicians, therapists, and counselors. |
| Who governs | The residents, by majority vote at a weekly business meeting. | The owner or operator, through documented house rules and policies. | An administrative organization with written policies and supervision. | A licensed treatment provider under clinical leadership. |
| Services provided | None by the residence. Residents arrange their own recovery support. | Drug and alcohol testing, meeting requirements, accountability. No treatment. | Structured weekly programming, individual service plans, life-skills development. | Group and individual therapy, clinical case management, medication management. |
| Typical length of stay | Open-ended. Residents stay as long as they follow the charter. | Several months to over a year, depending on the resident. | Defined by the service plan, commonly a few months. | Set by clinical necessity and the treatment plan. |
| State licensure | Not applicable. No clinical services are delivered. | Rarely required. Affiliate certification is the usual credential. | Varies by state. Confirm with your own state agency before committing. | Almost always required. The residence is delivering treatment. |
| Best suited for | Residents with established stability who want low cost and full autonomy. | Residents stepping down from inpatient treatment or a Level 3 program. | Residents who need structured guidance, often straight out of detox or inpatient care. | Residents needing clinical support alongside housing, typically straight from detox. |
| Operator reality | You are a landlord or a charter body, not a manager. If you set the rules, it is not Level 1. | The realistic starting level for a first-time operator, and where most independent homes sit. | You become an employer. Payroll, supervision, credentialing, and insurance all change. | Not an entry point. You become a licensed treatment provider first. |
Which NARR Level Should You Operate?
Almost every new recovery housing operator should open at Level 2. It is the only level that combines a certification path a first-time operator can complete, an operating cost structure that works without clinical billing, and enough structure to attract referrals from treatment providers and courts.
Work through four questions in order, and the answer usually resolves itself.
Will you employ anyone? If no, you are choosing between Level 1 and Level 2, and the deciding factor is whether you set the house rules. If yes, and those employees deliver scheduled programming, you are at Level 3 and taking on an employer’s obligations.
Will the residence deliver clinical services? If yes, you are at Level 4 and you need a state treatment license before you open a door. If no, Level 4 is off the table regardless of how much structure you provide.
Where will your residents come from? Referral sources have level expectations. Treatment providers discharging clients to sober living generally look for a certified Level 2 home. Drug courts and probation departments vary by jurisdiction. Ask your intended referral partners what they require before you design the home around a guess.
What does your state actually require? Certification is voluntary in most states and functionally necessary in several, and licensure rules change at Level 3. Verify this with your own state agency and NARR affiliate rather than with a national article, including this one.
The level you operate is a consequence of two decisions: whether you employ staff to deliver programming, and whether the residence delivers clinical services. Answer those two questions honestly and your NARR level is already chosen.
Levels are also not permanent. An operator who opens a certified Level 2 home and later builds staffing and structured programming can move to Level 3 with the same affiliate, and residences move the other way as well. The level describes what a residence does today, not what it is allowed to become.
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Read next How to Certify a Sober House: NARR Affiliate Certification
Frequently Asked Questions About NARR Levels of Care
What are the NARR levels of care?
The NARR levels of care are four tiers of recovery housing: Level 1 peer-run, Level 2 monitored, Level 3 supervised, and Level 4 clinical. Each level describes how much structure and service a residence provides. The National Alliance for Recovery Residences defines them in its National Standard 3.0.
What is the difference between a Level 1 and a Level 2 sober living home?
A Level 1 home has no paid staff and is governed by residents voting democratically. A Level 2 home is owner-operated, with written house rules and a House Mentor or senior resident on site providing accountability. The deciding question is who sets the rules: residents at Level 1, the operator at Level 2.
What is a Level 2 sober living home?
A Level 2 sober living home is an owner-operated, substance-free recovery residence that uses written house rules and peer accountability, with a House Mentor or senior resident on site. It provides testing and accountability but no clinical treatment. Most independently owned sober living homes in the United States are Level 2.
Which type of recovery housing has 24/7 clinical staff offering therapy and medication management?
Level 4, the clinical or service provider residence, is the level with credentialed clinical staff delivering therapy and medication management on site. Level 4 residences integrate the social and clinical models and are almost always operated by a licensed treatment provider under state license.
Do NARR levels require state licensing?
NARR levels themselves are not licenses. Certification against the NARR standard comes from a state affiliate and is voluntary in most states. State licensure is separate and generally applies once a residence delivers clinical services, which means Level 4 almost always and Level 3 depending on the state.
What NARR level do most sober living homes operate at?
Most sober living homes operate at Level 2, the monitored level. It is the level that fits an owner-operated home with house rules and a House Mentor but no clinical staff, and it is the level treatment providers most often look for when discharging clients into recovery housing.
Can a sober living home move from Level 1 to Level 2?
Yes. A residence changes level by changing what it does. Adding written house rules, an operator setting policy, and a House Mentor on site moves a peer-run Level 1 home to Level 2. The change is made through the state NARR affiliate that handles certification, not through NARR directly.
Research & Sources
- National Alliance for Recovery Residences. (2018). NARR standard 3.0. narronline.org
- National Alliance for Recovery Residences. (n.d.). Standards. narronline.org
- National Alliance for Recovery Residences. (n.d.). Affiliates. narronline.org
- Massachusetts Alliance for Sober Housing. (n.d.). Massachusetts sober homes law. mashsoberhousing.org
- Substance Abuse and Mental Health Services Administration. (n.d.). Best practices for recovery housing. samhsa.gov
The Vanderburgh Foundation, Inc. works alongside NARR affiliates in supporting recovery housing operators, and Vanderburgh Sober Living is the largest network of NARR-affiliate certified recovery homes in the United States. Nearly every VSL Chartered Recovery Home operates at Level 2, because that is the level where an independent operator can run a safe, certified, financially sustainable home without becoming a treatment provider. If you are weighing which level to open at, talk to our team.
