Provider Demographics
NPI:1417603812
Name:SOUL HOME CARE SERVICES, LLC
Entity Type:Organization
Organization Name:SOUL HOME CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:904-233-3989
Mailing Address - Street 1:8553 ARGYLE BUSINESS LOOP STE B
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-6669
Mailing Address - Country:US
Mailing Address - Phone:904-233-3989
Mailing Address - Fax:
Practice Address - Street 1:8553 ARGYLE BUSINESS LOOP STE B
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-6669
Practice Address - Country:US
Practice Address - Phone:904-233-3989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care