Provider Demographics
NPI:1134804719
Name:SOUL GARDENING LLC
Entity type:Organization
Organization Name:SOUL GARDENING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:774-321-5778
Mailing Address - Street 1:69 MONTGOMERY ST STE 3
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-2046
Mailing Address - Country:US
Mailing Address - Phone:401-307-1718
Mailing Address - Fax:
Practice Address - Street 1:69 MONTGOMERY ST STE 3
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-2046
Practice Address - Country:US
Practice Address - Phone:401-307-1718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty