Soul Provider LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

SOUL PROVIDER LLC

Practice address

3646 Caymus Dr
Sparks, NV 89436-7133

Phone

(775) 470-9718

NPI assigned

Dec 14, 2017

Organization subpart

No

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

Authorized official

Name

Kattie Smith

Title

Owner

Phone

(775) 470-9718

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1513209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524441600000",
    "number": "1881100774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3646 CAYMUS DR",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894367133",
            "telephone_number": "775-470-9718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3646 CAYMUS DR",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894367133",
            "telephone_number": "775-470-9718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL PROVIDER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-14",
        "last_updated": "2018-04-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KATTIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "775-470-9718"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Sofos
• Ericka Soliz
• Sierra Dawn Sorensen
• Darcy Sosebee
• Sonia Soto
• Sound Physicians Emergency Medicine of Nevada Bessler PLLC
• Kathleen Soyka
• Erica Johnetta Spaight
• Spalka Counseling
• Monica Jeanne Spalka

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Sparks, NV
• Providers in Sparks, NV by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; 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.