Healthcare Provider Details

I. General information

NPI: 1548839483
Provider Name (Legal Business Name): SOMA HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2021
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1736 OXMOOR RD STE 103
HOMEWOOD AL
35209-4053
US

IV. Provider business mailing address

233 WINTON BLOUNT LOOP
MONTGOMERY AL
36117-3507
US

V. Phone/Fax

Practice location:
  • Phone: 205-879-2120
  • Fax:
Mailing address:
  • Phone: 334-239-2622
  • Fax: 334-625-7602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHANKAR YALAMANCHILI
Title or Position: OWNER
Credential:
Phone: 334-239-2622