Provider Demographics
NPI:1639638331
Name:GALILEE MISSION
Entity Type:Organization
Organization Name:GALILEE MISSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:SERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-789-9390
Mailing Address - Street 1:1220 KINGSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02879-7909
Mailing Address - Country:US
Mailing Address - Phone:401-789-9390
Mailing Address - Fax:401-789-3454
Practice Address - Street 1:268 KINGSTOWN RD
Practice Address - Street 2:
Practice Address - City:NARRAGANSETT
Practice Address - State:RI
Practice Address - Zip Code:02882-3237
Practice Address - Country:US
Practice Address - Phone:401-789-9390
Practice Address - Fax:401-783-8155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-13
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251B00000XAgenciesCase Management
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder