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General NPI Number Information
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NPI Number | 1982552899
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Entity Type | Organization
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Legal Business Name | VANGUARD PSYCHIATRY AND WELLNESS, LLC
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Dates
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Enumeration Date | 03/17/2026
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Last Update Date | 03/21/2026
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Provider Practice Location Address
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Address Line | 10 DORRANCE ST STE 700
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City | PROVIDENCE
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State | RI
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Zip | 02903-2014
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Country | US
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Telephone | 401-447-4241
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Fax | 401-804-0401
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Provider Business Mailing Address
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Address Line | 10 DORRANCE ST STE 700
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City | PROVIDENCE
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State | RI
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Zip | 02903-2014
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Country | US
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Telephone | 401-447-4241
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. MOZART TELLES
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Credential | PMHNP
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Telephone | 401-447-4241
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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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