|Taxonomy Code||Specialty Code||Provider Type|
|LBN Legal business name||SOLACE WELLNESS MANAGEMENT SERVICE, LLC|
|Authorized official||EZEKIEL JOHNSON - (EXECUTIVE DIRECTOR)|
|Organization subpart 1||No|
|Last updated||05/07/2015 - More than a year ago|
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|JUDITH K GEER, PHD
6625 S RURAL ROAD
|LYDIA B GARRETT, PHD
1716 E MCNAIR DR
|DEBORAH DYER, PHD
1150 S. FOREST AVE SSV 334
|ALYSHA L BUNDY, PHD
1150 S FOREST AVE SSV334
|CAROL L HUNT
1300 E MISSOURI AVE., SUITE 100
|EDITH M MOORE, LAC
1300 E. MISSOURI AVE. SUITE A-100
|ALAN L OGUS, PH D
110 WEST CAMELBACK ROAD
|KATO D HAWS JR, MSW
235 S. EL DORADO CIR.
|DALIA ROSTENBERG, M.A.
6861 E OSBORN RD UNIT D
|CHAD H CLOSE, LISAC
650 W. SOUTHERN AVE.