| Radical Aba, Llc | |
|
2459 Maverick Way The Villages FL 32162-5101 | |
| (815) 262-8466 | |
| Not Available |
| Full Name | Radical Aba, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2459 Maverick Way, The Villages, Florida |
| Authorized Official Name and Position | Katherine Lynn Petrusa (MANAGING MEMBER) |
| Authorized Official Contact | 8152628466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Radical Aba, Llc 2459 Maverick Way The Villages FL 32162-5101 Ph: (815) 262-8466 | Radical Aba, Llc 2459 Maverick Way The Villages FL 32162-5101 Ph: (815) 262-8466 |
| NPI Number | 1922958180 |
|---|---|
| Provider Enumeration Date | 01/29/2026 |
| Last Update Date | 01/29/2026 |
| Certification Date | 01/29/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922958180 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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