Healthcare Provider Details

I. General information

NPI: 1033259478
Provider Name (Legal Business Name): THE JOURNEY TO HOPE, HEALTH & HEALING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 06/03/2020
Certification Date: 06/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

985 PLAINFIELD STREET
JOHNSTON RI
02919
US

IV. Provider business mailing address

985 PLAINFIELD STREET
JOHNSTON RI
02919-6703
US

V. Phone/Fax

Practice location:
  • Phone: 401-946-0650
  • Fax: 401-406-3771
Mailing address:
  • Phone: 401-946-0650
  • Fax: 401-406-3771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number StateRI

VIII. Authorized Official

Name: DIANA CHEKRALLAH
Title or Position: REGIONAL DIRECTOR
Credential:
Phone: 401-829-2654