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Organization
KOANN THERAPEUTIC SERVICES INC
Active
Organization
KOANN THERAPEUTIC SERVICES INC
Active
Parent organization
KOANN THERAPEUTIC SERVICES INC
Other names
Revive Therapeutic Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
KOANN THERAPEUTIC SERVICES INC
Authorized official
AKOS ANTWI (CEO)
(401) 648-7172
Entity
Organization
Contact information
Practice address
845 N MAIN ST STE L1B, PROVIDENCE, RI 02904-5775
(401) 648-7172
Mailing address
PO BOX 3085, PAWTUCKET, RI 02861-0585
(401) 648-7172
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/27/2025
Last updated
01/23/2026
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