Healthcare Provider Details

I. General information

NPI: 1194638304
Provider Name (Legal Business Name): COMPREHENSIVE COMMUNITY ACTION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 CRANSTON ST
CRANSTON RI
02920-7323
US

IV. Provider business mailing address

311 DORIC AVE
CRANSTON RI
02910-2903
US

V. Phone/Fax

Practice location:
  • Phone: 401-943-1981
  • Fax:
Mailing address:
  • Phone: 401-467-9610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: GINA E EUBANK
Title or Position: COO
Credential:
Phone: 401-562-8305