NPIMap

Organization Active NPI

Soul Solutions Recovery Center Inc

  • Community/Behavioral Health Agency
  • Fargo, ND
National Provider Identifier
1760056436
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SOUL SOLUTIONS RECOVERY CENTER INC
Practice address
1801 38TH St S
Fargo, ND 58103-4443
Phone
(701) 212-7965
NPI assigned
May 18, 2021
Last updated
May 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Authorized official

Name
Brenda Podetz
Title
Executive Director
Phone
(701) 212-7965

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1801 38TH St S
Fargo, ND 58103-4443

Mailing address

1801 38TH St S
Fargo, ND 58103-4443

National Provider Directory

National Provider Directory

Locations

1801 38th St S
Fargo, ND 58103
Phone (701) 356-7772

Practitioners & affiliated clinicians

Practitioners 7

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": "1621296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1760056436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 38TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 38TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034443",
            "telephone_number": "701-212-7965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL SOLUTIONS RECOVERY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "PODETZ",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "701-212-7965"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.