Healthcare Provider Details
I. General information
NPI: 1053319368
Provider Name (Legal Business Name): R.I.S.A.T., LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/11/2005
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1625 DIAMOND HILL RD
WOONSOCKET RI
02895-1541
US
IV. Provider business mailing address
PO BOX 682669
FRANKLIN TN
37068-2669
US
V. Phone/Fax
- Phone: 401-762-1511
- Fax: 401-762-1609
- Phone: 615-861-6000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2800X |
| Taxonomy | Methadone Clinic |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | 608.2 |
| License Number State | RI |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 276400000X |
| Taxonomy | Substance Use Disorder Rehabilitation Hospital Unit |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIAN
PHILLIP
FARLEY
Title or Position: VP & SECRETARY
Credential:
Phone: 615-716-9335