Healthcare Provider Details

I. General information

NPI: 1760258685
Provider Name (Legal Business Name): PREFERRED THERAPY OUTPATIENT SERVICES OF RI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2023
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 FOREST AVE
MIDDLETOWN RI
02842-7415
US

IV. Provider business mailing address

850 SILAS DEANE HWY FL 2
WETHERSFIELD CT
06109-3440
US

V. Phone/Fax

Practice location:
  • Phone: 860-918-4742
  • Fax:
Mailing address:
  • Phone: 860-610-0400
  • Fax: 860-610-0007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RACHAEL M PERCOCO
Title or Position: DIRECTOR OF OUTPATIENT SERVICES
Credential: PT
Phone: 860-918-4742