Organization
SOAR CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK SHVARTSBURD (CEO/PROGRAM SPONSOR)
(215) 322-6590
Entity
Organization
Contact information
Practice address
9150 MARSHALL ST, SUITE 2, PHILADELPHIA, PA 19114
(215) 464-4450
(215) 464-4405
Mailing address
9150 MARSHALL ST STE 18, PHILADELPHIA, PA 19114-2217
(215) 464-4450
(215) 464-4405
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM2800X
Methadone Clinic
Primary
807405
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020553790001
—
PA
Enumeration date
02/27/2008
Last updated
08/14/2018
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