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General NPI Number Information
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NPI Number | 1265880785
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Entity Type | Organization
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Legal Business Name | J ARTHUR TRUDEAU MEMORIAL CENTER
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Dates
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Enumeration Date | 05/25/2016
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Last Update Date | 05/25/2016
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Provider Practice Location Address
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Address Line | 3445 POST RD
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City | WARWICK
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State | RI
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Zip | 02886-7147
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Country | US
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Telephone | 401-739-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 58 LINDA DR
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City | COVENTRY
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State | RI
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Zip | 02816-7025
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Country | US
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Telephone | 401-269-1409
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | TRAVIS ROBINSON
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Credential | OTR/L
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Telephone | 401-269-1409
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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 | OT01564
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License Number State | RI
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