Healthcare Provider Details

I. General information

NPI: 1568580660
Provider Name (Legal Business Name): OCEAN STATE COMMUNITY RESOURCES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 SAYLES HILL RD
NORTH SMITHFIELD RI
02896-8255
US

IV. Provider business mailing address

310 MAPLE AVE SUITE 102
BARRINGTON RI
02806-3430
US

V. Phone/Fax

Practice location:
  • Phone: 401-766-5071
  • Fax:
Mailing address:
  • Phone: 401-245-7900
  • Fax: 401-245-7910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number187
License Number StateRI

VIII. Authorized Official

Name: MR. DAVID C REISS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 401-245-7900