Organization
CHOP-SOAR INTEGRATED AUTISM PROGRAM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IAN GOLDSTEIN (CEO)
(720) 706-3396
Entity
Organization
Contact information
Practice address
1700 MARKET ST, PHILADELPHIA, PA 19103-3913
(720) 706-3396
Mailing address
3401 QUEBEC ST STE 110, DENVER, CO 80207-2322
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
—
—
106S00000X
Behavior Technician
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/29/2024
Last updated
12/19/2025
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