Provider Demographics
NPI:1629135868
Name:SOAR ACADEMY
Entity Type:Organization
Organization Name:SOAR ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:ARNESS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:864-585-8928
Mailing Address - Street 1:PO BOX 3118
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29304-3118
Mailing Address - Country:US
Mailing Address - Phone:864-585-8928
Mailing Address - Fax:864-585-8929
Practice Address - Street 1:2407 S PINE ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-4335
Practice Address - Country:US
Practice Address - Phone:864-585-8928
Practice Address - Fax:864-585-8929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation