Healthcare Provider Details

I. General information

NPI: 1417746074
Provider Name (Legal Business Name): CALEB DUPLAN FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 NARRAGANSETT PARK DR STE 100
PAWTUCKET RI
02861-4326
US

IV. Provider business mailing address

700 NARRAGANSETT PARK DR STE 100
PAWTUCKET RI
02861-4326
US

V. Phone/Fax

Practice location:
  • Phone: 401-321-0404
  • Fax:
Mailing address:
  • Phone: 401-321-0404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MRS. MONET JEAN PHILIPPE
Title or Position: LCSW
Credential:
Phone: 401-321-0404