Healthcare Provider Details

I. General information

NPI: 1407638620
Provider Name (Legal Business Name): KP THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 S WATER ST UNIT 555
PROVIDENCE RI
02903-4344
US

IV. Provider business mailing address

551 S WATER ST UNIT 555
PROVIDENCE RI
02903-4344
US

V. Phone/Fax

Practice location:
  • Phone: 401-952-7637
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: MR. SHLOMI PEER
Title or Position: PRESIDENT
Credential:
Phone: 401-952-7637