NPIMap

Organization Active NPI

Soul Forward Sober Companions

  • Case Manager/Care Coordinator
  • Southfield, MI
National Provider Identifier
1174374797
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Legal business name
SOUL FORWARD SOBER COMPANIONS
Practice address
4000 Town Ctr Ste 1303
Southfield, MI 48075-1410
Phone
(248) 932-4000
NPI assigned
Apr 1, 2024
Last updated
Feb 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Claude Gracy Jr.NPI 1598516585
Title
Executive Director
Phone
(586) 339-2178

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X NU
Case Manager/Care Coordinator 171M00000X NU Primary

Addresses

Primary practice location

4000 Town Ctr Ste 1303
Southfield, MI 48075-1410

Mailing address

133 E Grand Blvd Apt 208
Detroit, MI 48207-3777
Phone (586) 339-2178

Other names 1

  • SOUL FORWARD SOBER COMPANIONS Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Soul Forward Sober Companions2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4000 Town Ctr
Ste 1303
Southfield, MI 48075
Phone (248) 932-4000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738886400000",
    "number": "1174374797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 E GRAND BLVD APT 208",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482073777",
            "telephone_number": "586-339-2178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 TOWN CTR STE 1303",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480751410",
            "telephone_number": "248-932-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL FORWARD SOBER COMPANIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-01",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A",
        "authorized_official_last_name": "GRACY",
        "authorized_official_first_name": "CLAUDE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "586-339-2178",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUL FORWARD SOBER COMPANIONS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SOUL FORWARD SOBER COMPANIONS",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "SOUL FORWARD SOBER COMPANIONS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.