Healthcare Provider Details

I. General information

NPI: 1871724070
Provider Name (Legal Business Name): PARI INDEPENDENT LIVING CENTER II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2009
Last Update Date: 08/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PROSPECT ST
PAWTUCKET RI
02860-6260
US

IV. Provider business mailing address

500 PROSPECT ST
PAWTUCKET RI
02860-6260
US

V. Phone/Fax

Practice location:
  • Phone: 401-725-1966
  • Fax: 401-725-2104
Mailing address:
  • Phone: 401-725-1966
  • Fax: 401-725-2104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: LEO CANUEL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 401-725-1966