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State Of Rhode Island And Providence Plantations
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Pascoag, Rhode Island
NPI 1104961242

State Of Rhode Island And Providence Plantations is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Pascoag, RI. State Of Rhode Island And Providence Plantations practices in Pascoag, RI. The NPI Number for State Of Rhode Island And Providence Plantations is 1104961242 and holds a License No. 48 (Rhode Island).

The current practice location address for State Of Rhode Island And Providence Plantations is 1710 East Wallum Lake Road, Pascoag, RI and can be reached out via phone at 401-567-0990.

Location: 1710 East Wallum Lake Road, Pascoag, RI, 02859-1825
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1104961242
Provider Name
State Of Rhode Island And Providence Plantations
Credential
Provider Entity Type
Organization
Address
1710 East Wallum Lake Road, Pascoag, RI, 02859-1825
Phone Number
401-567-0990
Fax Number
Provider Enumeration Date
02/20/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
EW12083 05 RI
institution
Provider Business Practice Location Address Details
Address
1710 East Wallum Lake Road
City
Pascoag
State
Rhode Island
Zip
02859-1825
Phone Number
401-567-0990
Fax Number
person
Provider Business Mailing Address Details
Address
1710 East Wallum Lake Road
City
Pascoag
State
Rhode Island
Zip
02859-1825
Phone Number
401-567-0990
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
48 (Rhode Island)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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