MEDICARE: LAFAYETTE CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency	29	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548395528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAFAYETTE CENTER

Provider Business Mailing Address
First Line	:	6 HARRINGTON RD
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02920-3080
Country	:	US
Telephone Number	:	401-462-2659
Fax Number	:	401-462-6631

Provider Business Practice Location Address
First Line	:	650 TEN ROD RD
Second Line	:
City	:	N KINGSTOWN
State	:	RI
Zip	:	02852-4238
Country	:	US
Telephone Number	:	401-294-6920
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. ELLEN R NELSON
Credential	:
Telephone Number	:	401-462-6001

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	08/22/2020

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Directions to “LAFAYETTE CENTER ” Practice Location

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