Healthcare Provider Details

I. General information

NPI: 1629212907
Provider Name (Legal Business Name): SELLATI & CO., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2009
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E ARLINGTON BOULEVARD SUITE C
GREENVILLE NC
27858-5019
US

IV. Provider business mailing address

1850 LEE RD SUITE 115
WINTER PARK FL
32789
US

V. Phone/Fax

Practice location:
  • Phone: 252-353-2555
  • Fax: 252-565-0137
Mailing address:
  • Phone: 407-677-1757
  • Fax: 407-678-1074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License NumberMHL-074-167
License Number StateNC

VIII. Authorized Official

Name: MRS. JANIE MARIE LARCH
Title or Position: DIRECTOR OF QUALITY AND COMPLIANCE
Credential: LPC, LSATP
Phone: 804-977-2892