MEDICARE: SPURWINK RI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2	251300000X	Local Education Agency (LEA)
3	251S00000X	Community/Behavioral Health Agency
4	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
5	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility
6	251C00000X	Developmentally Disabled Services Day Training Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	166	OTHER	RI	MHRH DDD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548217805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPURWINK RI

Provider Business Mailing Address
First Line	:	ONE SPURWINK PLACE
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02910-2012
Country	:	US
Telephone Number	:	401-781-4380
Fax Number	:	401-781-4396

Provider Business Practice Location Address
First Line	:	1 SPURWINK PL
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02910-2012
Country	:	US
Telephone Number	:	401-781-4380
Fax Number	:	401-781-4396

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. REGINA C HAYES
Credential	:
Telephone Number	:	401-781-4380

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	12/16/2025

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Directions to “SPURWINK RI ” Practice Location

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