Provider Demographics
NPI:1437571569
Name:SOAR SERVICES, INC.
Entity Type:Organization
Organization Name:SOAR SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TURGEON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:715-468-2841
Mailing Address - Street 1:PO BOX 265
Mailing Address - Street 2:
Mailing Address - City:SHELL LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:54871-0265
Mailing Address - Country:US
Mailing Address - Phone:715-468-2841
Mailing Address - Fax:715-468-2374
Practice Address - Street 1:246 INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:SHELL LAKE
Practice Address - State:WI
Practice Address - Zip Code:54871-8889
Practice Address - Country:US
Practice Address - Phone:715-468-2841
Practice Address - Fax:715-468-2374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2506261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1497939524Medicaid