Organization · Type 2 NPI
State of Rhode Island and Providence Plantations
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Pascoag, RI
Practice location
1710 East Wallum Lake Road
Pascoag, RI 02859-1825
Mailing address
1710 E Wallum Lake Rd
Pascoag, RI 02859-1825
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | 48 (RI) |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
About NPI 1104961242
State of Rhode Island and Providence Plantations's National Provider Identifier is 1104961242, issued on Feb 20, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Pascoag, RI. The record was last updated on Aug 22, 2019.