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NPI Code Detail

MEDICARE: SOAR 365

MEDICARE: SOAR 365
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist
2225100000XPhysical Therapist
3252Y00000XEarly Intervention Provider Agency
4235Z00000XSpeech-Language Pathologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578529566
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOAR 365
Provider Business Mailing Address
First Line : 3600 SAUNDERS AVE.
Second Line :
City : RICHMOND
State : VA
Zip : 23227-4347
Country : US
Telephone Number : 804-358-1874
Fax Number : 804-278-8977
Provider Business Practice Location Address
First Line : 3600 SAUNDERS AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23227-4328
Country : US
Telephone Number : 804-358-1874
Fax Number : 804-358-7595
Authorized Official
Title or Position : ACCOUNTING MANAGER
Name : SUE MITCHELL
Credential :
Telephone Number : 804-665-1255
Provider Enumeration Date : 04/26/2006
Last Update Date : 09/29/2025

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Directions to “SOAR 365 ” Practice Location

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