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General NPI Number Information
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NPI Number | 1548132673
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Entity Type | Organization
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Legal Business Name | RAPHA BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 984 CHARLES ST
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02904-5054
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Country | US
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Telephone | 401-935-1804
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Fax | 401-340-1904
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Provider Business Mailing Address
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Address Line | 984 CHARLES ST
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02904-5054
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Country | US
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Telephone | 401-935-1804
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Fax | 401-340-1904
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Authorized Official
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Title or Position | APRN
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Name | MOFOLUSO AGBELESE
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Credential |
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Telephone | 401-935-1804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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