Provider Demographics
NPI:1598800500
Name:THE SOUL FOCUS, INC
Entity Type:Organization
Organization Name:THE SOUL FOCUS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:910-343-8438
Mailing Address - Street 1:2539 CASTLE HAYNE ROAD
Mailing Address - Street 2:SUITE F
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-2591
Mailing Address - Country:US
Mailing Address - Phone:910-343-8438
Mailing Address - Fax:910-341-7945
Practice Address - Street 1:2539 CASTLE HAYNE ROAD
Practice Address - Street 2:SUITE F
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-2591
Practice Address - Country:US
Practice Address - Phone:910-343-8438
Practice Address - Fax:910-341-7945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300943HMedicaid
NC8300943BMedicaid
NC8300943Medicaid
NC8300943GMedicaid