Organization · Type 2 NPI

Nickerson Community Center

Emotionally Disturbed Childrens' Residential Treatment Facility · Providence, RI

NPI number 1457549578 Active

Practice location

97 Delaine St
Providence, RI 02909-2726

Mailing address

133 Delaine St
Providence, RI 02909-2728

Specialties and licenses

TaxonomyCodeLicense
Community/Behavioral Health Agency 251S00000XNone listed
Emotionally Disturbed Childrens' Residential Treatment Facility Primary 322D00000XNone listed

Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

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About NPI 1457549578

Nickerson Community Center's National Provider Identifier is 1457549578, issued on Oct 15, 2007. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Providence, RI. The record was last updated on Oct 15, 2007.