Healthcare Provider Details

I. General information

NPI: 1619814407
Provider Name (Legal Business Name): A&T ENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 IRWIN ST STE 302
SAN RAFAEL CA
94901-3343
US

IV. Provider business mailing address

851 IRWIN ST STE 302
SAN RAFAEL CA
94901-3343
US

V. Phone/Fax

Practice location:
  • Phone: 415-686-5783
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL TRIOLO
Title or Position: CEO
Credential:
Phone: 415-686-5783