Active NPI
Soul4Real
- Dietary Manager
- Southfield, MI
National Provider Identifier
1669386603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dietary Manager
- Legal business name
- SOUL4REAL
- Practice address
- 29673 Northwestern Hwy
Southfield, MI 48034-1033 - Phone
- (248) 629-0050
- NPI assigned
- Sep 29, 2026
- Last updated
- Sep 29, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tina L Phillips, OWNER
- Title
- Cfo
- Phone
- (313) 575-6229
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dietary Manager | 132700000X | NU | Primary |
Addresses
Primary practice location
29673 Northwestern Hwy
Southfield, MI 48034-1033
Mailing address
286 Alhambra St
Pontiac, MI 48341-1090
Phone (313) 575-6229
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790640000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790640000000",
"number": "1669386603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "286 ALHAMBRA ST",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483411090",
"telephone_number": "313-575-6229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29673 NORTHWESTERN HWY",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480341033",
"telephone_number": "248-629-0050"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUL4REAL",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-29",
"last_updated": "2026-09-29",
"certification_date": "2026-09-29",
"status": "A",
"authorized_official_last_name": "PHILLIPS",
"authorized_official_first_name": "TINA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "313-575-6229",
"authorized_official_credential": "OWNER"
},
"taxonomies": [
{
"code": "132700000X",
"taxonomy_group": "",
"desc": "Dietary Manager",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
- Freddy R Sosa, M.D.
- Yeva Soskina, M.D.
- Stephen Souaid, OTR/L
- Soul Forward Sober Companions
- Soul Grace Coaching Co,
- Sound Health (Sound Helth)
- South Field Rehabiltation Company (Oakland Regional Hospital, Oakland Regional Macomb Center)
- Anthony Southall, MD
- Southeast Home Health Care, L.L.C
- Southeast Rehabilitation and Physical Therapy Inc. (Southeast Rehabilitation)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.