Provider Demographics
NPI:1700325594
Name:SOMA INFANT & MATERNAL CARE INC
Entity Type:Organization
Organization Name:SOMA INFANT & MATERNAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AHLAM
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-TAMIMI
Authorized Official - Suffix:
Authorized Official - Credentials:SW
Authorized Official - Phone:313-989-2263
Mailing Address - Street 1:4115 SEYMOUR ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2956
Mailing Address - Country:US
Mailing Address - Phone:313-989-2263
Mailing Address - Fax:248-395-0222
Practice Address - Street 1:4115 SEYMOUR ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2956
Practice Address - Country:US
Practice Address - Phone:313-989-2263
Practice Address - Fax:248-395-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health