Healthcare Provider Details

I. General information

NPI: 1659292308
Provider Name (Legal Business Name): S.O.A.R. VOCATIONAL SOLUTIONS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8112 KELBURN LN
CHARLOTTE NC
28273-0633
US

IV. Provider business mailing address

8112 KELBURN LN
CHARLOTTE NC
28273-0633
US

V. Phone/Fax

Practice location:
  • Phone: 843-356-0719
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LATONYA BURGESS
Title or Position: VICE PRESIDENT/COO
Credential:
Phone: 843-350-0719