Healthcare Provider Details

I. General information

NPI: 1740115526
Provider Name (Legal Business Name): RHODE ISLAND CENTER FOR EATING RECOVERY AND PERFORMANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

439 BENEFIT ST
PROVIDENCE RI
02903-2934
US

IV. Provider business mailing address

439 BENEFIT ST
PROVIDENCE RI
02903-2934
US

V. Phone/Fax

Practice location:
  • Phone: 401-206-4206
  • Fax:
Mailing address:
  • Phone: 401-206-4206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER NADEAU
Title or Position: OWNDER
Credential: MD
Phone: 401-206-4206