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General NPI Number Information
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NPI Number | 1700010519
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Entity Type | Organization
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Legal Business Name | A ROAD TO RECOVERY, LLC
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Dates
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Enumeration Date | 05/07/2009
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Last Update Date | 05/14/2009
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Provider Practice Location Address
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Address Line | 6971 HERITAGE DR
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-8229
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Country | US
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Telephone | 772-466-7111
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Fax | 772-466-9991
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Provider Business Mailing Address
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Address Line | 6971 HERITAGE DR
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-8229
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Country | US
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Telephone | 772-466-7111
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Fax | 772-466-9991
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN P FERRARO
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Credential |
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Telephone | 772-466-7111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 1956AD393101
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License Number State | FL
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