Home Port Therapy | |
23 North Rd Ste A25 Peace Dale RI 02879-2176 | |
(401) 932-1181 | |
(401) 783-1154 |
Full Name | Home Port Therapy |
---|---|
Speciality | Clinic/center - Adult Mental Health |
Location | 23 North Rd Ste A25, Peace Dale, Rhode Island |
Authorized Official Name and Position | Reynard Bullock (OWNER) |
Authorized Official Contact | 4019321181 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Home Port Therapy 23 North Rd Ste A25 Peace Dale RI 02879-2176 Ph: () - | Home Port Therapy 23 North Rd Ste A25 Peace Dale RI 02879-2176 Ph: (401) 932-1181 |
NPI Number | 1740460872 |
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Provider Enumeration Date | 11/06/2007 |
Last Update Date | 11/06/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740460872 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0850X | Clinic/center - Adult Mental Health | MFT00100 (Rhode Island) | Primary |
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› Verified 8 days ago
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