Organization
EAST BAY COMMUNITY ACTION PROGRAM
Active
Other names
East Bay Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
RILWAN FEYISITAN (CEO)
(401) 437-1008
Entity
Organization
Contact information
Practice address
610 WAMPANOAG TRL, RIVERSIDE, RI 02915-1504
(401) 437-1008
(401) 433-3042
Mailing address
100 BULLOCKS POINT, RIVERSIDE, RI 02915
(401) 437-1008
(401) 433-3042
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
—
—
251S00000X
Community/Behavioral Health Agency
—
RI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
RI
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EA1247
—
RI
Enumeration date
06/08/2012
Last updated
03/23/2024
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