Healthcare Provider Details

I. General information

NPI: 1891869608
Provider Name (Legal Business Name): JEWISH SENIORS AGENCY OF RHODE ISLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 WATERMAN STREET
PROVIDENCE RI
02906
US

IV. Provider business mailing address

229 WATERMAN STREET
PROVIDENCE RI
02906
US

V. Phone/Fax

Practice location:
  • Phone: 401-351-4750
  • Fax: 401-421-5905
Mailing address:
  • Phone: 401-351-4750
  • Fax: 401-421-5905

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: PAUL R BARRETTE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 401-351-4750