ETHAN PLACE NPI 1780807347

NPI Information

NPI: 1780807347
Provider Name: ETHAN PLACE

Former Legal Business Name: OES HOME OF RI

Classification: Clinic/Center - 261QR0800X
Entity Type: Organization

Specialization: Recovery Care

Address:
85 ETHAN ST
WARWICK, RI
ZIP 02888
Phone: (401) 781-5460
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ETHAN PLACE is a recovery care clinic center in Warwick, RI. ETHAN PLACE NPI is 1780807347. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Oes Home Of Ri.

The provider's business location address is:

85 ETHAN ST
WARWICK, RI
ZIP 02888-905
Phone: (401) 781-5460
Fax: (401) 781-0479

The provider's authorized official is Sandra L. Lacross .
The authorized official title is Director and has the following contact phone number (401) 781-5460.

The CLIA number assigned to this NPI record is 41D1068590 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/11/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0800X	Clinic/Center	Recovery Care	207	RHODE ISLAND	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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