Healthcare Provider Details

I. General information

NPI: 1992569388
Provider Name (Legal Business Name): RHODE ISLAND STATE PSYCHIATRIC HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 HOWARD AVENUE
CRANSTON RI
02920
US

IV. Provider business mailing address

45 HOWARD AVE
CRANSTON RI
02920
US

V. Phone/Fax

Practice location:
  • Phone: 401-462-2780
  • Fax: 401-462-4052
Mailing address:
  • Phone: 401-462-4040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. IRINA BEYDER
Title or Position: CEO
Credential: PHD, MBA, LCMFT
Phone: 401-462-4040