Healthcare Provider Details

I. General information

NPI: 1225801731
Provider Name (Legal Business Name): NEWPORT COUNTY COMMUNITY MENTAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 12/27/2023
Certification Date: 12/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 JOHNNY CAKE HILL RD
MIDDLETOWN RI
02842-5674
US

IV. Provider business mailing address

127 JOHNNY CAKE HILL RD
MIDDLETOWN RI
02842-5674
US

V. Phone/Fax

Practice location:
  • Phone: 401-843-1213
  • Fax: 401-848-6398
Mailing address:
  • Phone: 401-843-1213
  • Fax: 401-848-6398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANN MARIE FORTE
Title or Position: CONTRACT LIAISON AND CREDENTIALING
Credential:
Phone: 401-848-1213