Healthcare Provider Details

I. General information

NPI: 1568327633
Provider Name (Legal Business Name): CHOP-SOAR INTEGRATED AUTISM PROGRAM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 BLACKSMITH RD STE 1
NEWTOWN PA
18940-1847
US

IV. Provider business mailing address

3401 QUEBEC ST STE 110
DENVER CO
80207-2322
US

V. Phone/Fax

Practice location:
  • Phone: 267-802-1701
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DANIEL SPIEGEL
Title or Position: SVP
Credential: MD
Phone: 618-851-1227