# KOANN THERAPEUTIC SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KOANN THERAPEUTIC SERVICES INC
- **Other names:** Revive Therapeutic Services
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1629861224
- **Legal business name:** KOANN THERAPEUTIC SERVICES INC
- **Authorized official:** AKOS ANTWI (CEO)
- **Authorized official phone:** (401) 648-7172

## Contact information

- **Practice address:** 845 N MAIN ST STE L1B, PROVIDENCE, RI 02904-5775
- **Practice address phone:** (401) 648-7172
- **Mailing address:** PO BOX 3085, PAWTUCKET, RI 02861-0585
- **Mailing address phone:** (401) 648-7172

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/27/2025
- **Last updated:** 01/23/2026