Organization
SOULBRIDGE HEALTH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FOLASHADE KANIMODO NURSE PRACTITIONER (DIRECTOR)
(410) 900-8897
Entity
Organization
Contact information
Practice address
418 BROADWAY # 10795, ALBANY, NY 12207-2922
(410) 900-8897
(410) 888-7145
Mailing address
418 BROADWAY # 10795, ALBANY, NY 12207-2922
(410) 900-8897
(410) 888-7145
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
01/26/2026
Last updated
01/26/2026
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