Organization
AUTISM SPORTS ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHIL SGROI IV MA (TEACHER)
(201) 674-3363
Entity
Organization
Contact information
Practice address
435 HOLLYWOOD AVE STE 11, FAIRFIELD, NJ 07004-2406
(551) 280-3172
Mailing address
36 MELROSE AVE, NORTH ARLINGTON, NJ 07031-5918
(551) 280-3172
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/28/2023
Last updated
07/07/2023
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