Healthcare Provider Details

I. General information

NPI: 1558094805
Provider Name (Legal Business Name): AMOUR DE SOI BEHAVIORAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2022
Last Update Date: 07/05/2022
Certification Date: 07/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 PRESIDENT AVE
FALL RIVER MA
02720-5923
US

IV. Provider business mailing address

83 OHIO ST
NEW BEDFORD MA
02745-2725
US

V. Phone/Fax

Practice location:
  • Phone: 774-644-3002
  • Fax: 774-307-4144
Mailing address:
  • Phone: 774-644-3002
  • Fax: 774-307-4144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: RACHEL GRACE FOLGER
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: PMHNP-BC
Phone: 774-644-3002