Organization
GREATER TEXAS BEHAVIORAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS PETRILLO (CEO/OWNER)
(978) 440-3200
Entity
Organization
Contact information
Practice address
5006 LAKELAND CIR STE 208, WACO, TX 76710-2971
(877) 590-3665
Mailing address
621 NW 53RD ST STE 370, BOCA RATON, FL 33487-8241
(978) 440-3200
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
09/25/2024
Last updated
05/05/2025
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