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General NPI Number Information
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NPI Number | 1639799539
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Entity Type | Organization
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Legal Business Name | ROGERS HOME INC
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Dates
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Enumeration Date | 04/21/2020
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Last Update Date | 04/21/2020
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Provider Practice Location Address
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Address Line | 105 BEECHWOOD AVE
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City | PAWTUCKET
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State | RI
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Zip | 02860-5409
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Country | US
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Telephone | 401-996-4379
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Fax |
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Provider Business Mailing Address
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Address Line | 1361 BROAD ST
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City | CENTRAL FALLS
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State | RI
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Zip | 02863-1004
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Country | US
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Telephone | 401-996-4379
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT/DIRECTOR
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Name | FRANK MOREAU
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Credential |
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Telephone | 401-996-4379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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