Provider Demographics
NPI:1023359122
Name:P AND R RECOVERY SERVICES LLC
Entity Type:Organization
Organization Name:P AND R RECOVERY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:C
Authorized Official - Last Name:LETENDRE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LCDP
Authorized Official - Phone:401-741-3490
Mailing Address - Street 1:11 KING CHARLES DR
Mailing Address - Street 2:A2
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871-1446
Mailing Address - Country:US
Mailing Address - Phone:401-741-3490
Mailing Address - Fax:401-293-0142
Practice Address - Street 1:11 KING CHARLES DR
Practice Address - Street 2:A2
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-1446
Practice Address - Country:US
Practice Address - Phone:401-741-3490
Practice Address - Fax:401-293-0142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI612261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder