Provider Demographics
NPI:1700010519
Name:A ROAD TO RECOVERY, LLC
Entity Type:Organization
Organization Name:A ROAD TO RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:FERRARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-466-7111
Mailing Address - Street 1:6971 HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-8229
Mailing Address - Country:US
Mailing Address - Phone:772-466-7111
Mailing Address - Fax:772-466-9991
Practice Address - Street 1:6971 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-8229
Practice Address - Country:US
Practice Address - Phone:772-466-7111
Practice Address - Fax:772-466-9991
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IMAGE MANAGEMENT CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-07
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1956AD393101324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility