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General NPI Number Information
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NPI Number | 1639843303
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Entity Type | Organization
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Legal Business Name | KOANN THERAPEUTIC SERVICES INC
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Dates
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Enumeration Date | 08/05/2021
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 845 N MAIN ST
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City | PROVIDENCE
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State | RI
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Zip | 02904-5700
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Country | US
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Telephone | 401-648-7172
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Fax | 401-648-0161
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Provider Business Mailing Address
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Address Line | PO BOX 3085
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City | PAWTUCKET
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State | RI
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Zip | 02861-0585
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER/CEO
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Name | AKOS ANTWI
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Credential |
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Telephone | 401-648-7172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #7
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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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