Provider Demographics
NPI:1871227645
Name:SOUL PSYCHIATRY -FAMILY CARE
Entity type:Organization
Organization Name:SOUL PSYCHIATRY -FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:BROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-PMHNP
Authorized Official - Phone:801-369-4544
Mailing Address - Street 1:533 N NOVA RD STE 203
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-4422
Mailing Address - Country:US
Mailing Address - Phone:386-672-7175
Mailing Address - Fax:386-672-0771
Practice Address - Street 1:533 N NOVA RD STE 203
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-4422
Practice Address - Country:US
Practice Address - Phone:386-672-7175
Practice Address - Fax:386-672-0771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Single Specialty