MEDICARE: SOREC INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	175T00000X	Peer Specialist
2	261QH0100X	Health Service Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1265092290
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOREC INC.

Provider Business Mailing Address
First Line	:	1789 S BRADDOCK AVE STE 550
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15218-1880
Country	:	US
Telephone Number	:	412-723-1749
Fax Number	:	412-346-4319

Provider Business Practice Location Address
First Line	:	1789 S BRADDOCK AVE STE 550
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15218-1880
Country	:	US
Telephone Number	:	412-723-1749
Fax Number	:	412-346-4319

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	BARRY GILLIAM
Credential	:
Telephone Number	:	412-723-1749

Provider Enumeration Date	:	06/20/2019
Last Update Date	:	09/09/2022

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Directions to “SOREC INC. ” Practice Location

Language	Start Address	Practice Location

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