Healthcare Provider Details

I. General information

NPI: 1144681701
Provider Name (Legal Business Name): RHODE ISLAND REHABILITATION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2016
Last Update Date: 03/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 RESERVOIR AVE
CRANSTON RI
02910-4430
US

IV. Provider business mailing address

721 RESOVOIR AVENUE
CRANSTON RI
02910
US

V. Phone/Fax

Practice location:
  • Phone: 401-946-4250
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HENRY SISUN
Title or Position: OWNER
Credential:
Phone: 401-946-4250