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CRANSTON ARC

Residential Treatment Mental Retardation

Providence, Rhode Island

Provider NPI: 1225169832

Organization Information:
Organization Name:  CRANSTON ARC
Authorized Official:  PAT  COPPAGE  FINANCIAL DIRECTOR  401-9411112

Practice Location:
129 MOOREFIELD ST  PROVIDENCE, RI 02909 US
Tel: 401-941-1112  Fax: 401-941-2516

Business Mailing Address:
111 COMSTOCK PKWY  CRANSTON, RI 02921 US
Tel: 401-941-1112  Fax: 401-941-2516

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y320600000XResidential Treatment Facilities
Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities
RI30

Other Provider Identifiers:

IssuerNumberStateType
EDS PROVIDER NUMBERAC02744RI01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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