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Organization

SOMA CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD WADE DNP (DNP/AUTHORIZED OFFICIAL)
(480) 550-7460
Entity
Organization

Contact information

Practice address
6944 E BROADWAY RD STE A, MESA, AZ 85208-1916
(480) 550-7460
(480) 459-2805
Mailing address
6944 E BROADWAY RD STE A, MESA, AZ 85208-1916
(480) 550-7460
(480) 459-2805

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
363LP2300X
Primary Care Nurse Practitioner

Other

Enumeration date
08/31/2020
Last updated
08/31/2020
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