Provider Demographics
NPI:1154108603
Name:CORE OF HOPE PSYCHIATRY LLC
Entity type:Organization
Organization Name:CORE OF HOPE PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANILLE
Authorized Official - Middle Name:LEANA
Authorized Official - Last Name:LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:401-484-3094
Mailing Address - Street 1:PO BOX 321
Mailing Address - Street 2:
Mailing Address - City:BURRILLVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02830-0321
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 RESERVOIR AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-6012
Practice Address - Country:US
Practice Address - Phone:401-484-3094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-08
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty