Provider Demographics
NPI:1417733882
Name:SOAR TRANSITIONAL HOMES AND RECOVERY CENTERS OF NELA
Entity Type:Organization
Organization Name:SOAR TRANSITIONAL HOMES AND RECOVERY CENTERS OF NELA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NASIR
Authorized Official - Middle Name:AL-HAJJ
Authorized Official - Last Name:MUHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-395-6619
Mailing Address - Street 1:201 CENTURY VILLAGE BLVD STE 247
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-2006
Mailing Address - Country:US
Mailing Address - Phone:318-395-6619
Mailing Address - Fax:318-575-4054
Practice Address - Street 1:201 CENTURY VILLAGE BLVD STE 247
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-2006
Practice Address - Country:US
Practice Address - Phone:318-395-6619
Practice Address - Fax:318-575-4054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty