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General NPI Number Information
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NPI Number | 1144509720
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Entity Type | Organization
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Legal Business Name | DISCOVERY HOUSE
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Dates
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Enumeration Date | 08/12/2011
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Last Update Date | 08/12/2011
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Provider Practice Location Address
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Address Line | 1625 DIAMOND HILL RD
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City | WOONSOCKET
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State | RI
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Zip | 02895-1541
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Country | US
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Telephone | 401-762-1511
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Fax |
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Provider Business Mailing Address
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Address Line | 1625 DIAMOND HILL RD
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City | WOONSOCKET
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State | RI
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Zip | 02895-1541
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Country | US
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Telephone | 401-762-1511
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Fax |
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Authorized Official
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Title or Position | SUBSTANCE ABUSE COUNSELOR
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Name | MS. LYDIA M COUTO
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Credential | LADCII
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Telephone | 401-762-1511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1032
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License Number State | MA
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