Provider Demographics
NPI:1962277442
Name:RHEMA PSYCHIATRIC SERVICES LLC
Entity type:Organization
Organization Name:RHEMA PSYCHIATRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:
Authorized Official - Last Name:IRIOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:857-693-5631
Mailing Address - Street 1:136 FERNCROFT RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-2609
Mailing Address - Country:US
Mailing Address - Phone:857-693-5631
Mailing Address - Fax:844-328-4876
Practice Address - Street 1:185 PERKINS AVE
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-4207
Practice Address - Country:US
Practice Address - Phone:857-693-5631
Practice Address - Fax:844-328-4876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-15
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health