1033259478 NPI number — THE JOURNEY TO HOPE, HEALTH & HEALING, INC

Table of content: (NPI 1033259478)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033259478 NPI number — THE JOURNEY TO HOPE, HEALTH & HEALING, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE JOURNEY TO HOPE, HEALTH & HEALING, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CENTER FOR BEHAVIORAL HEALTH-R.I., INC.
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033259478
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
985 PLAINFIELD STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JOHNSTON
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02919-6703
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-946-0650
Provider Business Mailing Address Fax Number:
401-406-3771

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
985 PLAINFIELD STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNSTON
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-946-0650
Provider Business Practice Location Address Fax Number:
401-406-3771
Provider Enumeration Date:
02/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CHEKRALLAH
Authorized Official First Name:
DIANA
Authorized Official Middle Name:
Authorized Official Title or Position:
REGIONAL DIRECTOR
Authorized Official Telephone Number:
401-829-2654

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM2800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM2800X , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 276400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: BH01421 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".




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