Provider Demographics
NPI:1669527248
Name:SOAR, INC
Entity type:Organization
Organization Name:SOAR, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTANO
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:828-226-5533
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:BALSAM
Mailing Address - State:NC
Mailing Address - Zip Code:28707-0250
Mailing Address - Country:US
Mailing Address - Phone:828-226-5533
Mailing Address - Fax:828-452-1300
Practice Address - Street 1:1904 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-6790
Practice Address - Country:US
Practice Address - Phone:828-452-1300
Practice Address - Fax:828-452-1300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
NCMHL-044-046251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301068Medicaid