SACRED SOUL WELLNESS LLC (NPI# 1982259180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982259180 |
| Entity Type | Organization |
| Organization Name | SACRED SOUL WELLNESS LLC |
| Practice Address |
445 Dexter Ave Ste 4050 Montgomery AL 36104-3867 |
| Mailing Address |
4260 Knollgate Rd Montgomery AL 36116-5522 |
| Practice Telephone | 3343331632 |
| Mailing Telephone | 3343331632 |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2019-08-05 |
| Authorized Official Name | DR. TIFFANY TAFT (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3343331632 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| INDIVIDUAL | 1174016471 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SACRED SOUL WELLNESS LLC | 445 Dexter Ave, Suite 4050, Montgomery, AL 36104-3867 |
| Street Address |
445 DEXTER AVE STE 4050 |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36104-3867 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275515850 | Fc of Alabama Inc | Home Health | 445 Dexter Ave Ste 4050, Montgomery, AL 36104-3867 | 2005-11-18 |
| 1073128286 | Let's Talk, LLC | Community/Behavioral Health | 445 Dexter Ave Ste 4050, Montgomery, AL 36104-3867 | 2020-09-14 |
| 1154894467 | Bml Transportation Services LLC | Non-emergency Medical Transport (VAN) | 445 Dexter Ave Ste 4050, Montgomery, AL 36104-3867 | 2019-01-09 |
| 1184177651 | Cleve Carter IIi | Physical Therapist | 445 Dexter Ave Ste 4050, Montgomery, AL 36104-3867 | 2016-08-01 |
| 1083031512 | Thomas James Hardy Jr. | Non-emergency Medical Transport (VAN) | 445 Dexter Ave Ste 4050, Montgomery, AL 36104-3867 | 2014-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518597707 | Henley Counseling LLC | Counselor | 445 Dexter Avenue, Suite 4050, Montgomery, AL 36104 | 2020-01-16 |
| 1164994489 | Cornwall Transportation LLC | Non-emergency Medical Transport (VAN) | 2 N Jackston St #605, Montgomery, AL 36104 | 2018-12-27 |
| 1093237661 | Dianna Delane Havard | Speech-Language Pathologist | 602 South Lawrence Street, Montgomery, AL 36104 | 2017-07-14 |
| 1992149884 | Marshall Eye Care | Optometrist | 241 N Court St Apt H, Montgomery, AL 36104 | 2013-04-22 |
| 1689923237 | Beryl Sabb | Counselor | 321 North Hull Street, Montgomery, AL 36104 | 2012-08-29 |
| 1033478318 | William Foster | Social Worker | 207 Montgomery Street, Suite 313, Montgomery, AL 36104 | 2012-05-08 |
| 1972877363 | William Alex Ward | Driver | 906 South Perry Street, Suite 103, Montgomery, AL 36104 | 2012-03-02 |
| 1356669915 | Seib Pharmacy | Pharmacy | 101 South Union Street, Montgomery, AL 36104 | 2010-05-06 |
| 1376797282 | Joseph Anthony Mangini | Family Medicine | 300 S Hull St, Montgomery, AL 36104 | 2008-11-05 |
| 1154572840 | State of Alabama Department of Public Health | Public Health or Welfare | 201 Monroe Street, Suite 1080, Montgomery, AL 36104 | 2008-10-01 |
| Find all providers in zip 36104 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417564527 | Huldah Deberry | Massage Therapist | 8449 Crossland Loop Ste 108, Montgomery, AL 36117-0917 | 2020-09-23 |
| 1225649791 | Oasis Massage and Bodywork, Inc. | Massage Therapist | 5287 Vaughn Rd, Montgomery, AL 36116-1104 | 2020-08-10 |
| 1174141428 | Nicholas Pernell Vines Sr. | Massage Therapist | 2201 Sagewood Dr, Montgomery, AL 36117-2428 | 2020-07-13 |
| 1245854017 | Danney Lester Hendrix | Massage Therapist | 5485 Atlanta Hwy, Root Salon Building, Montgomery, AL 36109 | 2020-06-08 |
| 1881139731 | Nikki Roberts | Massage Therapist | 7111 Halcyon Park Dr Ste B, Montgomery, AL 36117-7714 | 2017-01-02 |
| 1811290935 | Charles Warren Clark Jr. | Massage Therapist | 19577 Fm 2854 Rd, Montgomery, TX 77316-3150 | 2010-12-11 |
| 1558698050 | Laura Lee Svatek | Massage Therapist | 211 Cool Cove, Montgomery, TX 77356 | 2009-11-04 |
| 1649507179 | Sheila Jean Mistric | Massage Therapist | 24563 Clark Rd, Montgomery, TX 77316-3876 | 2009-11-04 |
| 1023345501 | Desaray Leigh Rich | Massage Therapist | 15260 Highway 105 W # 125, Montgomery, TX 77356-5259 | 2009-11-04 |
| 1962655332 | Kathy J Stricker | Massage Therapist | 518 Paradise Ln, Montgomery, TX 77356-5725 | 2008-10-29 |
| Find all providers in MONTGOMERY | ||||
| City | MONTGOMERY |
| Zip Code | 36104 |
Please comment or provide details below to improve the information on SACRED SOUL WELLNESS LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.