Home Port Therapy
NPI #1740460872 in Peace Dale, Rhode Island
Provider Information
- NPI Number
- 1740460872
- Entity Type
- Organization
- Organization Name
- Home Port Therapy
- Primary Specialty
- Clinic/Center - Adult Mental Health
- Enumeration Date
- Nov 6, 2007
- Last Updated
- Nov 6, 2007
Practice Location
- Address
- 23 NORTH RD STE A25
- City
- Peace Dale
- State
- Rhode Island
- ZIP Code
- 02879-2176
- Phone
- (401) 932-1181
Authorized Official
- Name
- MR. REYNARD BULLOCK, MS LMFT
- Title
- OWNER
- Phone
- (401) 932-1181
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Adult Mental Health — Adult Mental Health |
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