Provider Demographics
NPI:1548132673
Name:RAPHA BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:RAPHA BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:MOFOLUSO
Authorized Official - Middle Name:
Authorized Official - Last Name:AGBELESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-935-1804
Mailing Address - Street 1:984 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-5054
Mailing Address - Country:US
Mailing Address - Phone:401-935-1804
Mailing Address - Fax:401-340-1904
Practice Address - Street 1:984 CHARLES ST
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-5054
Practice Address - Country:US
Practice Address - Phone:401-935-1804
Practice Address - Fax:401-340-1904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty