Organization
SOAR CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD A MANGANO (VICE PRESIDENT)
(215) 464-4450
Entity
Organization
Contact information
Practice address
7500 BRISTOL PIKE, LEVITTOWN, PA 19057
(215) 464-4450
(215) 464-4470
Mailing address
9150 MARSHALL ST, SUITE 18, PHILADELPHIA, PA 19114-2217
(215) 464-4450
(215) 464-4470
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM2800X
Methadone Clinic
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102055379
—
PA
Enumeration date
08/24/2016
Last updated
08/14/2018
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