Provider Demographics
NPI:1457402356
Name:CATHOLIC CHARITIES OF THE DIOCESE OF VENICE INC
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES OF THE DIOCESE OF VENICE INC
Other - Org Name:CATHOLIC CHARITIES DIOCESE OF VENICE INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUTSIS-ARROYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-379-9111
Mailing Address - Street 1:5055 N TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34234-3803
Mailing Address - Country:US
Mailing Address - Phone:941-355-4680
Mailing Address - Fax:941-359-8374
Practice Address - Street 1:4930 FRUITVILLE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-2206
Practice Address - Country:US
Practice Address - Phone:941-379-9111
Practice Address - Fax:941-379-3611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL07-006266251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health