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General NPI Number Information
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NPI Number | 1376863043
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Entity Type | Organization
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Legal Business Name | SOAR CORP
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Dates
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Enumeration Date | 06/04/2010
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Last Update Date | 08/31/2018
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Provider Practice Location Address
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Address Line | 33 WILLIAMS ST
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City | LANSDOWNE
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State | PA
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Zip | 19050
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Country | US
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Telephone | 610-622-1114
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Fax |
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Provider Business Mailing Address
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Address Line | 33 WILLIAMS ST
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City | LANSDOWNE
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State | PA
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Zip | 19050-2730
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Country | US
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Telephone | 610-622-1114
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING
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Name | CHRISTINE K CAMPLING
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Credential |
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Telephone | 610-931-1217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number | 237089
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License Number State | PA
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