Provider Demographics
NPI:1467080168
Name:SOAR SOLUTIONS, LLC
Entity Type:Organization
Organization Name:SOAR SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:AHAVA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:478-595-3400
Mailing Address - Street 1:105 BARCLAY RD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-1403
Mailing Address - Country:US
Mailing Address - Phone:478-595-3400
Mailing Address - Fax:
Practice Address - Street 1:105 BARCLAY RD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-1403
Practice Address - Country:US
Practice Address - Phone:478-595-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-29
Last Update Date:2020-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health