Organization
SOAR SUPPORTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID TOMASELLI (OPERATOR/DIRECTOR)
(986) 282-0029
Entity
Organization
Contact information
Practice address
271 N. AVE. D, KUNA, ID 83634
(986) 282-0029
Mailing address
2528 N HICKORY WAY, MERIDIAN, ID 83646-8077
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
07/01/2025
Last updated
07/01/2025
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