GREATER PROVIDENCE CHAPTER,RIARC (NPI# 1124144928) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124144928 |
| Entity Type | Organization |
| Organization Name | GREATER PROVIDENCE CHAPTER,RIARC |
| Other Organization Name | JOHN E. FOGARTY CENTER |
| Practice Address |
40 Leander St Providence RI 02909-5636 |
| Mailing Address |
220 Woonasquatucket Ave North Providence RI 02911-3196 |
| Practice Telephone | 4012723162 |
| Practice Fax Number | 4013530290 |
| Mailing Telephone | 4013536990 |
| Mailing Fax Number | 4013530290 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JOHN COSTA (CONTROLLER) |
| Authorized Official Telephone | 4013536990 |
| Authorized Official Credential | BS, CPP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 91 | RI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | JF02837 | 05 |
| Other Name | Type Code |
|---|---|
| JOHN E. FOGARTY CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447376264 | Greater Providence Chapter,riarc | Intermediate Care Facility, Mentally Retarded | 1 Roland St, Riverside, RI 02915-3315 | 2007-03-22 |
| 1760508501 | Greater Providence Chapter,riarc | Intermediate Care Facility, Mentally Retarded | 2 Testa Cir, North Scituate, RI 02857-1870 | 2007-03-22 |
| 1063538502 | Greater Providence Chapter,riarc | Intermediate Care Facility, Mentally Retarded | 212 Leah St, Providence, RI 02908-3906 | 2007-03-22 |
| 1326164146 | Greater Providence Chapter,riarc | Intermediate Care Facility, Mentally Retarded | 181 Ridge Rd, Smithfield, RI 02917-2504 | 2007-03-22 |
| 1457477168 | Greater Providence Chapter,riarc | Intermediate Care Facility, Mentally Retarded | 7 Tallyho Rd, Cumberland, RI 02864-3911 | 2007-03-22 |
| 1427174234 | Greater Providence Chapter,riarc | Intermediate Care Facility, Mentally Retarded | 9 Howard Ave, North Providence, RI 02911-1838 | 2007-03-22 |
| 1245356955 | Greater Providence Chapter,riarc | Intermediate Care Facility, Mentally Retarded | 109 Sherwood St, Providence, RI 02908-1617 | 2007-03-22 |
| 1285750075 | Greater Providence Chapter,riarc | Intermediate Care Facility, Mentally Retarded | 1460 Douglas Ave, North Providence, RI 02904-4032 | 2007-03-22 |
| 1609992163 | Greater Providence Chapter,riarc | Day Training, Developmentally Disabled Services | 220 Woonasquatucket Ave, North Providence, RI 02911-3196 | 2007-03-22 |
| Street Address |
40 LEANDER ST |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02909-5636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578021754 | Roberta Bellas Portugal | Registered Nurse | Behave Care, 188 Valley St, Providence, RI 02909 | 2019-03-07 |
| 1912137324 | Catherine Elaine Tuttle | Social Worker | 623 Atwells Avenue, Suite 201, Providence, RI 02909 | 2009-07-20 |
| 1477736452 | City Dental, LLC | Dentist | 314f Pocasset Avenue, Providence, RI 02909 | 2007-12-12 |
| 1245449651 | Walter R. Vandyck | Occupational Therapist | Springfield Middle School, Providene School Department, 152 Springfield St, Providence, RI 02909 | 2007-05-22 |
| 1780805283 | Marcel A Trisvan | Counselor | Codac Providence, 349 Huntington Ave, Providence, RI 02909 | 2007-05-01 |
| 1215153945 | Codac Inc | Peer Specialist | 349 Huntington Ave, Codac Providence, Providence, RI 02909 | 2007-04-18 |
| 1316076342 | Mulak Chiropractic Center Inc | Chiropractor | 411 Broadway, Providence, RI 02909 | 2007-03-05 |
| 1710042742 | Michael Antonio Pensa | Chiropractor | 45 Eagle St Bld J Unit 100, Providence, RI 02909 | 2006-12-27 |
| 1780768234 | Providence Community Action | Case Management | 662 Hartford Avenue, Providence, RI 02909 | 2006-10-24 |
| 1881629608 | Cora Brigid Mayer | Counselor | 623 Atwells Ave., Communities for People, Inc., Providence, RI 02909 | 2006-07-11 |
| Find all providers in zip 02909 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770045742 | Community Residences, Inc. Rhode Island | Intermediate Care Facility, Mentally Retarded | Community Residences, Inc. Rhode Island, 10 Dorrance Street, Suite 706, Providence, RI 02903-2003 | 2019-04-01 |
| 1063538502 | Greater Providence Chapter,riarc | Intermediate Care Facility, Mentally Retarded | 212 Leah St, Providence, RI 02908-3906 | 2007-03-22 |
| 1245356955 | Greater Providence Chapter,riarc | Intermediate Care Facility, Mentally Retarded | 109 Sherwood St, Providence, RI 02908-1617 | 2007-03-22 |
| 1366442899 | The Tavares Pediatric Center Inc | Intermediate Care Facility, Mentally Retarded | 101 Plain St, Providence, RI 02903-4824 | 2005-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447376264 | Greater Providence Chapter,riarc | Intermediate Care Facility, Mentally Retarded | 1 Roland St, Riverside, RI 02915-3315 | 2007-03-22 |
| 1760508501 | Greater Providence Chapter,riarc | Intermediate Care Facility, Mentally Retarded | 2 Testa Cir, North Scituate, RI 02857-1870 | 2007-03-22 |
| 1326164146 | Greater Providence Chapter,riarc | Intermediate Care Facility, Mentally Retarded | 181 Ridge Rd, Smithfield, RI 02917-2504 | 2007-03-22 |
| 1457477168 | Greater Providence Chapter,riarc | Intermediate Care Facility, Mentally Retarded | 7 Tallyho Rd, Cumberland, RI 02864-3911 | 2007-03-22 |
| 1427174234 | Greater Providence Chapter,riarc | Intermediate Care Facility, Mentally Retarded | 9 Howard Ave, North Providence, RI 02911-1838 | 2007-03-22 |
| 1649396417 | Greater Providence Chapter, Riarc | Intermediate Care Facility, Mentally Retarded | 120 Angell Rd, Lincoln, RI 02865-4709 | 2007-03-22 |
| 1407972284 | Greater Providence Chapter, Riarc | Intermediate Care Facility, Mentally Retarded | 22 Buratti Rd, Johnston, RI 02919-3217 | 2007-03-22 |
| 1285750075 | Greater Providence Chapter,riarc | Intermediate Care Facility, Mentally Retarded | 1460 Douglas Ave, North Providence, RI 02904-4032 | 2007-03-22 |
| 1447375985 | The Arc of Blackstone Valley | Intermediate Care Facility, Mentally Retarded | 109 Earl Ave, Riverside, RI 02915-3205 | 2007-03-21 |
| 1396860730 | The Arc of Blackstone Valley | Intermediate Care Facility, Mentally Retarded | 305 Owen Ave, Pawtucket, RI 02860-1521 | 2007-03-21 |
| Find all providers with the same taxonomy | ||||
| City | PROVIDENCE |
| Zip Code | 02909 |
Please comment or provide details below to improve the information on GREATER PROVIDENCE CHAPTER,RIARC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.