Delta Soul Medical, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

DELTA SOUL MEDICAL, LLC

Practice address

102 N. Pearman Ave.
Ste. 1
Cleveland, MS 38732

Phone

(662) 843-0006

Fax

(662) 843-0002

NPI assigned

Jul 10, 2010

Last updated

Jul 10, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Zeyad Kamel Kassem

Title

Ceo

Phone

(248) 830-4662

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Cole Clark

  • Respite Care
  • Cleveland, MS
  • NPI 1538556436
  NPD (past)

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

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278720000000",
    "number": "1386956027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N BERKSHIRE RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020401",
            "telephone_number": "248-830-4662",
            "fax_number": "248-322-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N. PEARMAN AVE.",
            "address_2": "STE. 1",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "38732",
            "telephone_number": "662-843-0006",
            "fax_number": "662-843-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA SOUL MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-10",
        "last_updated": "2010-07-10",
        "status": "A",
        "authorized_official_last_name": "KASSEM",
        "authorized_official_first_name": "ZEYAD",
        "authorized_official_middle_name": "KAMEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-830-4662",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delta Physical Therapy PLLC
• Delta Radiology PLLC
• Delta Rehabilitation and Healthcare Center of Cleveland, LLC
• Delta Soul Medical Homecare
• Delta Soul Medical Homecare, LLC
• Delta State University
• Delta Vein and Artery Center, P. C.
• Delta Wound Care PLLC
• Delta Wound Care Services Inc.
• Mallory McKnight Dill

• Community Based Hospice Care Agency in Cleveland, MS
• Providers in Cleveland, MS by specialty
• Community Based Hospice Care Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2010; 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.