Provider Demographics
NPI:1578021754
Name:PORTUGAL, ROBERTA BELLAS (RN)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:BELLAS
Last Name:PORTUGAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 BARON RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-4202
Mailing Address - Country:US
Mailing Address - Phone:401-474-1321
Mailing Address - Fax:
Practice Address - Street 1:BEHAVE CARE
Practice Address - Street 2:188 VALLEY ST
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909
Practice Address - Country:US
Practice Address - Phone:401-648-6200
Practice Address - Fax:877-985-7622
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN51687163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health