| Map Behavioral Health Services Inc. | |
|
66 Burnett Street Providence RI 02907 | |
| (401) 785-0050 | |
| (401) 941-0089 |
| Full Name | Map Behavioral Health Services Inc. |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 66 Burnett Street, Providence, Rhode Island |
| Authorized Official Name and Position | Lionel H. Fernandez (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4017850050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Map Behavioral Health Services Inc. 66 Burnett Street Providence RI 02907 Ph: (401) 785-0050 | Map Behavioral Health Services Inc. 66 Burnett Street Providence RI 02907 Ph: (401) 785-0050 |
| NPI Number | 1821218587 |
|---|---|
| Provider Enumeration Date | 04/26/2007 |
| Last Update Date | 07/14/2023 |
| Certification Date | 07/14/2023 |
| Medicare PECOS PAC ID | 6800218470 |
|---|---|
| Medicare Enrollment ID | O20230720003196 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821218587 | NPI | - | NPPES |
| MA01418 | Medicaid | RI | |
| 1022060 | Other | RI | NEIGHBORHOOD HEALTH |
| Provider Name | Marian E Idahosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962973164 PECOS PAC ID: 2769720788 Enrollment ID: I20190215001887 |
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