Provider Demographics
NPI:1720876147
Name:TORCHLIGHT WELLNESS LLC
Entity type:Organization
Organization Name:TORCHLIGHT WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:AGU
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-388-0422
Mailing Address - Street 1:700 NARRAGANSETT PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02861-4326
Mailing Address - Country:US
Mailing Address - Phone:401-388-0422
Mailing Address - Fax:888-586-2207
Practice Address - Street 1:700 NARRAGANSETT PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02861-4326
Practice Address - Country:US
Practice Address - Phone:401-388-0422
Practice Address - Fax:888-586-2207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-26
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic MedicineGroup - Single Specialty