Organization
CHILD CARE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT GUSSONI (FOUNDER/CEO)
(469) 993-8028
Entity
Organization
Contact information
Practice address
1756 HALIFAX ST, ROANOKE, TX 76262
(310) 975-5043
Mailing address
1756 HALIFAX ST, ROANOKE, TX 76262-1388
(469) 993-8028
(844) 269-9518
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3625592
—
TX
Enumeration date
04/09/2015
Last updated
06/30/2018
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