Healthcare Provider Details

I. General information

NPI: 1881130235
Provider Name (Legal Business Name): MML SENIOR CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2017
Last Update Date: 01/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7291 POST RD
NORTH KINGSTOWN RI
02852-3212
US

IV. Provider business mailing address

7291 POST RD
NORTH KINGSTOWN RI
02852-3212
US

V. Phone/Fax

Practice location:
  • Phone: 401-667-2923
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: CRISTIAN DERSIDAN
Title or Position: PRESIDENT
Credential:
Phone: 401-667-2923