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General NPI Number Information
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NPI Number | 1134222441
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Entity Type | Organization
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Legal Business Name | STATEWIDE HEALTH SERVICES INC
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2905 POST RD STE 5
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City | WARWICK
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State | RI
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Zip | 02886-3174
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Country | US
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Telephone | 401-738-7775
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Fax | 401-737-0414
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Provider Business Mailing Address
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Address Line | 2905 POST RD STE 5
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City | WARWICK
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State | RI
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Zip | 02886-3174
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Country | US
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Telephone | 401-738-7775
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Fax | 401-737-0414
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | MRS. SANDRA A DIONNE
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Credential | RN 16150 REGISTERED
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Telephone | 401-738-7775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HCP02436
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License Number State | RI
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