Provider Demographics
NPI:1912707076
Name:SOUL SPOT NON-PROFIT INC
Entity type:Organization
Organization Name:SOUL SPOT NON-PROFIT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VAUGHN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ADAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-748-5360
Mailing Address - Street 1:3417E POIPU RD STE 107A
Mailing Address - Street 2:
Mailing Address - City:KOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96756-8528
Mailing Address - Country:US
Mailing Address - Phone:808-431-3332
Mailing Address - Fax:
Practice Address - Street 1:3417E POIPU RD STE 107A
Practice Address - Street 2:
Practice Address - City:KOLOA
Practice Address - State:HI
Practice Address - Zip Code:96756-8528
Practice Address - Country:US
Practice Address - Phone:808-431-3332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty