| NPI | 1578345914 |
|---|---|
| Doing Business As | ANTHONY DEFAZIO, LCADC LLC |
| Entity Type | Organization |
| Authorized Contact | ANTHONY J DEFAZIO Owner 173-298-4126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2023-10-19 |
| Last Update Date | 2023-10-19 |