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General NPI Number Information
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NPI Number | 1841323094
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Entity Type | Organization
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Legal Business Name | SSTAR OF RHODE ISLAND, INC.
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 04/08/2014
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Provider Practice Location Address
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Address Line | 80 EAST ST
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City | CRANSTON
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State | RI
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Zip | 02920-4421
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Country | US
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Telephone | 401-463-6001
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Fax | 401-463-8572
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Provider Business Mailing Address
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Address Line | 386 STANLEY ST
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City | FALL RIVER
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State | MA
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Zip | 02720-6009
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Country | US
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Telephone | 508-235-7010
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Fax | 508-646-9482
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MRS. DIANE GOUVEIA
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Credential | LICSW
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Telephone | 401-463-6001
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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 | 617.1
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 617
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License Number State | RI
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