Healthcare Provider Details

I. General information

NPI: 1043546088
Provider Name (Legal Business Name): TRI-TOWN ECONOMIC OPPORTUNITY COMMITTEE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2009
Last Update Date: 10/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1126 HARTFORD AVE
JOHNSTON RI
02919-7109
US

IV. Provider business mailing address

1126 HARTFORD AVE
JOHNSTON RI
02919-7109
US

V. Phone/Fax

Practice location:
  • Phone: 401-351-2750
  • Fax: 401-349-3125
Mailing address:
  • Phone: 401-351-2750
  • Fax: 401-349-3125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH R DESANTIS
Title or Position: CEO
Credential:
Phone: 401-351-2750