Provider Demographics
NPI:1508475880
Name:RI THERAPEUTIC ALLIANCE, LLC
Entity Type:Organization
Organization Name:RI THERAPEUTIC ALLIANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MAILHOT
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-526-3211
Mailing Address - Street 1:PO BOX 32
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-0779
Mailing Address - Country:US
Mailing Address - Phone:401-526-3211
Mailing Address - Fax:
Practice Address - Street 1:18 HILLTOP DR
Practice Address - Street 2:
Practice Address - City:N SCITUATE
Practice Address - State:RI
Practice Address - Zip Code:02857-1215
Practice Address - Country:US
Practice Address - Phone:401-526-3211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
1679028831OtherNPI