NPI 1407972284

Greater Providence Chapter, Riarc

Organisation Intellectual Disabilities Intermediate Care Facility Johnston, RI

Practice location

Address: 22 Buratti Rd, Johnston, RI 02919-3217
Phone: (401) 521-2212
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 44 (RI)

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

Registry record

NPI: 1407972284
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.