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General NPI Number Information
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NPI Number | 1215152780
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Entity Type | Organization
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Legal Business Name | SOUTH COUNTY COMMUNITY ACTION
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 01/29/2009
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Provider Practice Location Address
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Address Line | 1935 KINGSTOWN RD
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City | WAKEFIELD
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State | RI
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Zip | 02879-1616
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Country | US
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Telephone | 401-789-3016
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Fax | 401-515-0139
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Provider Business Mailing Address
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Address Line | 1935 KINGSTOWN RD
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City | WAKEFIELD
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State | RI
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Zip | 02879-1616
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Country | US
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Telephone | 401-789-3016
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Fax | 401-515-0139
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JOSEPH R. DESANTIS
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Credential |
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Telephone | 401-789-3016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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