Provider Demographics
NPI:1962862615
Name:SOAR BEHAVIOR SERVICES
Entity Type:Organization
Organization Name:SOAR BEHAVIOR SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, MA, BCBA
Authorized Official - Phone:509-999-5657
Mailing Address - Street 1:11707 E SPRAGUE AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-6124
Mailing Address - Country:US
Mailing Address - Phone:509-999-5657
Mailing Address - Fax:509-590-4333
Practice Address - Street 1:11707 E SPRAGUE AVE STE 106
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-6124
Practice Address - Country:US
Practice Address - Phone:509-999-5657
Practice Address - Fax:509-590-4333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health