Soho Wellness Initiative, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

504735707061 Issued in FL

Legal business name

SOHO WELLNESS INITIATIVE, LLC

Practice address

4801 S Congress Ave Ste 120
Palm Springs, FL 33461-4746

Phone

(561) 214-7614

Fax

(561) 293-8278

NPI assigned

Mar 20, 2017

Organization subpart

No

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

Authorized official

Name

Natasha Khan

Title

Ceo

Phone

(561) 214-7614

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1205377462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 S CONGRESS AVE., STE. 120",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "33461",
            "telephone_number": "561-214-7614",
            "fax_number": "561-293-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 S CONGRESS AVE STE 120",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334614746",
            "telephone_number": "561-214-7614",
            "fax_number": "561-293-8278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOHO WELLNESS INITIATIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "NATASHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-214-7614"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "FL",
            "license": "504735707061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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.