Healthcare Provider Details

I. General information

NPI: 1881735389
Provider Name (Legal Business Name): JUSTICE RESOURCE INSTITUTE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 09/25/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2346 POST ROAD SUITE 104
WARWICK RI
02886
US

IV. Provider business mailing address

160 GOULD ST SUITE 300
NEEDHAM MA
02494
US

V. Phone/Fax

Practice location:
  • Phone: 401-944-5694
  • Fax: 401-946-0365
Mailing address:
  • Phone: 781-559-4900
  • Fax: 781-559-4901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number296
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: BISSER DOKOV
Title or Position: CFO & EVP
Credential:
Phone: 781-559-4900