NPI 1063538502

Greater Providence Chapter,riarc

Organisation Intellectual Disabilities Intermediate Care Facility Providence, RI

Practice location

Address: 212 Leah St, Providence, RI 02908-3906
Phone: (401) 751-0347
Fax: (401) 353-0290
Mailing address: 220 Woonasquatucket Ave, North Providence, RI 02911-3196

Authorised official

Name: John Costa
Title: Controller
Phone: (401) 353-6990

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 249 (RI)

Other Intermediate Care Facility, Intellectual Disabilities providers in Rhode Island →

Registry record

NPI: 1063538502
Entity type: Organization
NPI issued: 22 Mar 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.