Healthcare Provider Details

I. General information

NPI: 1275663221
Provider Name (Legal Business Name): TRI-TOWN ECONOMIC OPPORTUNITY COMMITTEE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 06/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 PUTNAM PIKE ADULT DAY SERVICE BUILDING
GREENVILLE RI
02828-1428
US

IV. Provider business mailing address

1126 HARTFORD AVE
JOHNSTON RI
02919-7109
US

V. Phone/Fax

Practice location:
  • Phone: 401-949-3890
  • Fax: 401-949-5666
Mailing address:
  • Phone: 401-351-2750
  • Fax: 401-351-6611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1
License Number StateRI

VIII. Authorized Official

Name: MR. JOSEPH DESANTIS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 401-351-2750