Organization
SOULCARE HEALTH, LLC
Active
Organization
SOULCARE HEALTH, LLC
Active
Other names
Soulcare Health, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
GLORY O OSADIAYE APRN (PMHNP)
(678) 978-4151
Entity
Organization
Contact information
Practice address
250 CONSTITUTION BLVD, LAWRENCEVILLE, GA 30046-8432
(470) 844-0157
(678) 539-8899
Mailing address
780 MARTIN FIELD DR, LAWRENCEVILLE, GA 30045-5270
(678) 978-4151
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
02/13/2023
Last updated
05/26/2023
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