Provider Demographics
NPI:1952852691
Name:THE JOURNEY HOPE, HEALTH & HEALING, INC
Entity Type:Organization
Organization Name:THE JOURNEY HOPE, HEALTH & HEALING, INC
Other - Org Name:CENTER FOR BEHAVIORAL HEALTH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEKRALLAH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, ACDP
Authorized Official - Phone:401-946-0650
Mailing Address - Street 1:985 PLAINFIELD ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-6703
Mailing Address - Country:US
Mailing Address - Phone:401-946-0650
Mailing Address - Fax:401-946-2407
Practice Address - Street 1:985 PLAINFIELD ST
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-6703
Practice Address - Country:US
Practice Address - Phone:401-946-0650
Practice Address - Fax:401-946-2407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICDP00619101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI601100138Medicaid