Shannock Road Group Home
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Wakefield, Rhode Island
1912032079- Practice location
- 794 Shannock RD, Wakefield, RI 02879-4756
- Phone
- 401-462-7829
- Fax
- —
- Last updated
- August 22, 2020
Shannock Road Group Home is a healthcare organization based in Wakefield, RI. Shannock Road Group Home practices in Wakefield, RI. The NPI Number for Shannock Road Group Home is 1912032079 and holds a License No. 15 (RI). The current practice location address for Shannock Road Group Home is 794 Shannock RD, Wakefield, RI 02879-4756 and can be reached out via phone at 401-462-7829.
Provider Profile Details
- NPI Number
- 1912032079
- Provider Name
- Shannock Road Group Home
- Provider Entity Type
- Organization
- Address
- 794 Shannock RD, Wakefield, RI 02879-4756
- Phone Number
- 401-462-7829
- Primary Taxonomy
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities · 320900000X
- Organization Subpart
- No
- Authorized Official
- Ms. Ellen R Nelson · Director · 401-462-6001
- Provider Enumeration Date
- February 22, 2007
- Last Update Date
- August 22, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 794 Shannock RD
Wakefield, RI 02879-4756 - City
- Wakefield
- State
- Rhode Island
- Zip
- 02879-4756
- Phone Number
- 401-462-7829
Provider Business Mailing Address Details
- Address
- 6 Harrington RD
Cranston, RI 02920-3080 - City
- Cranston
- State
- RI
- Zip
- 02920-3080
- Phone Number
- 401-462-2659
- Fax Number
- 401-462-6631
License Information
- License Number
- 15
- License State
- RI
- Taxonomy
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities · 320900000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Shannock Road Group Home?
The NPI number of Shannock Road Group Home is 1912032079. It was assigned on February 22, 2007 and is currently active in the NPPES registry.
What is the specialty of Shannock Road Group Home?
Shannock Road Group Home is registered under the primary taxonomy Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (code 320900000X), licensed in RI under license number 15.
Where does Shannock Road Group Home practice?
The practice location is 794 Shannock RD, Wakefield, RI 02879-4756. The office can be reached at 401-462-7829 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1912032079 directly on the NPPES registry website.