Healthcare Provider Details

I. General information

NPI: 1205686664
Provider Name (Legal Business Name): RIVER OAKS TREATMENT CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2024
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12018 BOYETTE RD
RIVERVIEW FL
33569-5631
US

IV. Provider business mailing address

500 WILSON PIKE CIR STE 360
BRENTWOOD TN
37027-3266
US

V. Phone/Fax

Practice location:
  • Phone: 813-295-7762
  • Fax: 813-605-5735
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: JOHN T SANNUTO
Title or Position: FACILITY EXECUTIVE DIRECTOR
Credential: RN
Phone: 813-605-3900