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General NPI Number Information
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NPI Number | 1235821570
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Entity Type | Organization
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Legal Business Name | SOAR TRANSITIONAL HOMES AND RECOVERY CENTERS OF NELA
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 11/16/2023
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Provider Practice Location Address
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Address Line | 201 CENTURY VILLAGE BLVD STE 247
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City | MONROE
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State | LA
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Zip | 71203-2006
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Country | US
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Telephone | 318-953-6476
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Fax | 833-687-8328
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Provider Business Mailing Address
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Address Line | 201 CENTURY VILLAGE BLVD STE 247
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City | MONROE
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State | LA
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Zip | 71203-2006
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Country | US
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Telephone | 318-953-6476
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Fax | 833-687-8328
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NASIR AL-HAJJ MUHAMMAD
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Credential |
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Telephone | 833-687-8328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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