Provider Demographics
NPI:1285407957
Name:SOULUTION WELLNESS INC.
Entity type:Organization
Organization Name:SOULUTION WELLNESS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:J
Authorized Official - Last Name:MELIA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:516-983-1825
Mailing Address - Street 1:63 SOMERSET AVE
Mailing Address - Street 2:
Mailing Address - City:MASTIC
Mailing Address - State:NY
Mailing Address - Zip Code:11950-4214
Mailing Address - Country:US
Mailing Address - Phone:516-983-1825
Mailing Address - Fax:
Practice Address - Street 1:63 SOMERSET AVE
Practice Address - Street 2:
Practice Address - City:MASTIC
Practice Address - State:NY
Practice Address - Zip Code:11950-4214
Practice Address - Country:US
Practice Address - Phone:516-983-1825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)