| Soar Behavioral Health, Llc | |
|
700 Flume Run Apt 102 Newport News VA 23602-8900 | |
| (478) 595-3400 | |
| Not Available |
| Full Name | Soar Behavioral Health, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 700 Flume Run Apt 102, Newport News, Virginia |
| Authorized Official Name and Position | Glenn W Ahava (PSYCHOLOGIST/SOLE MEMBER) |
| Authorized Official Contact | 4785953400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soar Behavioral Health, Llc 700 Flume Run Apt 102 Newport News VA 23602-8900 Ph: (478) 595-3400 | Soar Behavioral Health, Llc 700 Flume Run Apt 102 Newport News VA 23602-8900 Ph: (478) 595-3400 |
| NPI Number | 1730926916 |
|---|---|
| Provider Enumeration Date | 07/13/2024 |
| Last Update Date | 07/13/2024 |
| Certification Date | 07/13/2024 |
| Medicare PECOS PAC ID | 2668992496 |
|---|---|
| Medicare Enrollment ID | O20250225000470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730926916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TF0200X | Psychologist - Forensic | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Glenn W Ahava |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508172859 PECOS PAC ID: 6608054291 Enrollment ID: I20250225000625 |
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