# COMPLETE HEALTH PRIMARY CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316516768
- **Authorized official:** JEREMY HILLIS MHC (OWNER)
- **Authorized official phone:** (401) 259-0340

## Contact information

- **Practice address:** 215 TOLL GATE RD STE 309, WARWICK, RI 02886-4463
- **Practice address phone:** (401) 259-0340
- **Mailing address:** 1150 RESERVOIR AVE STE 203, CRANSTON, RI 02920-6043
- **Mailing address phone:** (401) 259-0340
- **Mailing address fax:** (401) 213-8538

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/21/2021
- **Last updated:** 06/21/2021