Healthcare Provider Details

I. General information

NPI: 1386374015
Provider Name (Legal Business Name): JUSTICE ASSISTANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 PONTIAC AVE
CRANSTON RI
02920-4472
US

IV. Provider business mailing address

1540 PONTIAC AVE
CRANSTON RI
02920-4472
US

V. Phone/Fax

Practice location:
  • Phone: 401-781-7000
  • Fax:
Mailing address:
  • Phone: 401-781-0537
  • Fax: 401-781-1062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: FRANCES DALOMBA
Title or Position: CLINICAL DIRECTOR
Credential:
Phone: 401-781-7000