Station Street Group Home

NPI 1447385513 - Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities - 320900000X

NPI Details
NPI 1447385513
Enumeration Date 02/22/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 12 years ago
Authorized Information
Name ELLEN R ELLEN
Position DIRECTOR
Phone (401) 822-2320
Fax
Practice Location
204 STATION ST
COVENTRY RI, 02816-8455, US
Phone (401) 822-2320
Fax
Business Location
6 HARRINGTON RD
CRANSTON RI, 02920-3080, US
Phone (401) 462-2659
Fax (401) 462-6631
Toxanomy
Taxonomy Code 320900000X
License State Rhode Island
License Number 179
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According to our database, Station Street Group Home NPI is 1447385513, taxonomy code is 320900000X and license number is 179, license state is located at Rhode Island. Station Street Group Home physically located at 204 Station St, Coventry RI, 02816-8455. NPI Number 1033115704 has the healthcare provider type.

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1447385513 NPI number is provided on an as is basis without warranty of any kind. 1447385513 is maintained by the National Plan & Provider Enumeration System. The contents of Station Street Group Home are for informational purposes only.