Healthcare Provider Details

I. General information

NPI: 1003045782
Provider Name (Legal Business Name): GALILEE MISSION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2009
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 KINGSTOWN RD STE A
WAKEFIELD RI
02879-7909
US

IV. Provider business mailing address

1220 KINGSTOWN RD STE A
WAKEFIELD RI
02879-7909
US

V. Phone/Fax

Practice location:
  • Phone: 401-789-9390
  • Fax: 401-789-3454
Mailing address:
  • Phone: 401-789-9390
  • Fax: 401-789-3454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number611
License Number StateRI

VIII. Authorized Official

Name: MRS. LYNN ELAINE SERRA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 401-789-9390