Healthcare Provider Details

I. General information

NPI: 1538334792
Provider Name (Legal Business Name): COMMUNITY CARE ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 07/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CLINTON ST
WOONSOCKET RI
02895-3245
US

IV. Provider business mailing address

PO BOX 1700
WOONSOCKET RI
02895-0856
US

V. Phone/Fax

Practice location:
  • Phone: 401-235-7000
  • Fax:
Mailing address:
  • Phone: 401-235-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BENEDICT F LESSING JR.
Title or Position: CEO/PRESIDENT
Credential: MSW
Phone: 401-235-7000