MEDICARE: GIRLS AND BOYS TOWN OF NEW ENGLAND

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	11475218	RI
2	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	45920	RI
3	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	46885	RI
4	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	47109	RI
5	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	48180	RI
6	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	48222	RI

General Provider Information

NPI Number	:	1548388085
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIRLS AND BOYS TOWN OF NEW ENGLAND

Provider Business Mailing Address
First Line	:	31 KING CHARLES DR STE A
Second Line	:
City	:	PORTSMOUTH
State	:	RI
Zip	:	02871-1365
Country	:	US
Telephone Number	:	401-683-9870
Fax Number	:

Provider Business Practice Location Address
First Line	:	31 KING CHARLES DR STE A
Second Line	:
City	:	PORTSMOUTH
State	:	RI
Zip	:	02871-1365
Country	:	US
Telephone Number	:	401-683-9870
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	WILLIAM B REARDON
Credential	:	MS
Telephone Number	:	401-683-9870

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	09/11/2025

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Directions to “GIRLS AND BOYS TOWN OF NEW ENGLAND ” Practice Location

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