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General NPI Number Information
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NPI Number | 1780409987
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Entity Type | Organization
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Legal Business Name | SOAR CENTER LLC
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 255 HIGHWAY 70
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City | TOMS RIVER
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State | NJ
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Zip | 08755-1026
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Country | US
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Telephone | 732-813-7627
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Fax |
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Provider Business Mailing Address
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Address Line | 2360 RT 9 STE 3, SUIT 102
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City | TOMS RIVER
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State | NJ
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Zip | 08755-1933
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Country | US
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Telephone | 323-244-5176
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | BILL TEICHMAN
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Credential |
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Telephone | 323-244-5176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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