| Phoenix House Of New England | |
|
1058 Kingstown Rd Wakefield RI 02879-2487 | |
| (401) 783-0782 | |
| (401) 783-1154 |
| Full Name | Phoenix House Of New England |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1058 Kingstown Rd, Wakefield, Rhode Island |
| Authorized Official Name and Position | Reynard Lorin Bullock (COUNSELOR) |
| Authorized Official Contact | 4017830782 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix House Of New England 1058 Kingstown Rd Wakefield RI 02879-2487 Ph: (401) 783-0782 | Phoenix House Of New England 1058 Kingstown Rd Wakefield RI 02879-2487 Ph: (401) 783-0782 |
| NPI Number | 1790804292 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790804292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 00100 (Rhode Island) | Primary |
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