Healthcare Provider Details

I. General information

NPI: 1720628894
Provider Name (Legal Business Name): LOVE AND COMPASSION DAY HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2020
Last Update Date: 01/07/2020
Certification Date: 01/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 EAST AVE
PAWTUCKET RI
02860-4004
US

IV. Provider business mailing address

92 EAST AVE
PAWTUCKET RI
02860-4004
US

V. Phone/Fax

Practice location:
  • Phone: 401-390-0002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARIO MANCEBO
Title or Position: DIRECTOR
Credential:
Phone: 401-390-0002