Healthcare Provider Details

I. General information

NPI: 1902753643
Provider Name (Legal Business Name): LA MAISON COMMUNITY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 S MAIN ST # F
BRADFORD RI
02808-1235
US

IV. Provider business mailing address

5 S MAIN ST # F
BRADFORD RI
02808-1235
US

V. Phone/Fax

Practice location:
  • Phone: 484-475-8431
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ADELIN DUPONT
Title or Position: MANAGER
Credential:
Phone: 484-475-8431