Healthcare Provider Details

I. General information

NPI: 1720133267
Provider Name (Legal Business Name): CITY OF CRANSTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 08/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 CRANSTON ST
CRANSTON RI
02920-7344
US

IV. Provider business mailing address

1070 CRANSTON ST
CRANSTON RI
02920-7344
US

V. Phone/Fax

Practice location:
  • Phone: 401-780-6243
  • Fax: 401-780-6140
Mailing address:
  • Phone: 401-780-6243
  • Fax: 401-780-6140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberRIDEA #6
License Number StateRI

VIII. Authorized Official

Name: MS. THERESA MURPHY
Title or Position: EXECUTIVE DIRECTOR, CRANTON DEPARTM
Credential:
Phone: 401-780-6189