Soul Purpose Sober Living LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

SOUL PURPOSE SOBER LIVING LLC

Practice address

3667 El Camino Rd
Las Vegas, NV 89103-1102

Phone

(702) 488-4918

NPI assigned

Jan 25, 2019

Organization subpart

No

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

Authorized official

Name

Robert Ditomaso

Title

Owner

Phone

(702) 488-4918

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1548374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549497600000",
    "number": "1407310279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3667 EL CAMINO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891031102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3667 EL CAMINO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891031102",
            "telephone_number": "702-488-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL PURPOSE SOBER LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-25",
        "last_updated": "2019-02-07",
        "status": "A",
        "authorized_official_last_name": "DITOMASO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-488-4918"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE",
            "identifier": "NV20171125758",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anwar Akram Soudah, BSC
• Mehran Soudbakhsh, D.C.
• Steven Souder
• Tiffany Souksengdao
• Soul Journey LLC
• Emad Soumi, M.D.
• John Soumi, DDS
• Rasha Soumi
• Sound Mind and Body Mobile Healthcare Services, LLC
• Sound Mind and Body Mobile Healthcare Services, LLC

• Multi-Specialty Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Multi-Specialty Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; 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.