Provider Demographics
NPI:1003281023
Name:SOTO HEALTHCARE GROUP LLC
Entity Type:Organization
Organization Name:SOTO HEALTHCARE GROUP LLC
Other - Org Name:ABLE TREE ATC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-426-4200
Mailing Address - Street 1:3736 EXECUTIVE CENTER DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-2360
Mailing Address - Country:US
Mailing Address - Phone:706-426-4200
Mailing Address - Fax:
Practice Address - Street 1:3736 EXECUTIVE CENTER DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-2360
Practice Address - Country:US
Practice Address - Phone:706-426-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOTO HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty