Phoenix House of New England
NPI #1790804292 in Wakefield, Rhode Island
Provider Information
- NPI Number
- 1790804292
- Entity Type
- Organization
- Organization Name
- Phoenix House of New England
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Mar 28, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1058 KINGSTOWN RD
- City
- Wakefield
- State
- Rhode Island
- ZIP Code
- 02879-2487
- Phone
- (401) 783-0782
Authorized Official
- Name
- MR. REYNARD LORIN BULLOCK, MS LMFT
- Title
- COUNSELOR
- Phone
- (401) 783-0782
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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