Healthcare Provider Details

I. General information

NPI: 1518435882
Provider Name (Legal Business Name): LIKE HOME ADULT DAYCARE HEALTH CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 04/22/2020
Certification Date: 04/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 N MAIN ST
PROVIDENCE RI
02904-5700
US

IV. Provider business mailing address

845 N MAIN ST
PROVIDENCE RI
02904-5700
US

V. Phone/Fax

Practice location:
  • Phone: 401-274-1020
  • Fax: 401-274-1021
Mailing address:
  • Phone: 401-274-1020
  • Fax: 401-274-1021

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: NATIVIDAD MERCEDES
Title or Position: OWNER/MANAGER
Credential:
Phone: 401-523-3233