Organization
LATIN ADULT DAY HEALTH CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARIO MANCEBO (DIRECTOR)
(401) 709-2392
Entity
Organization
Contact information
Practice address
663 CHARLES ST, PROVIDENCE, RI 02904-1350
(401) 709-2392
(401) 603-0912
Mailing address
665 CHARLES ST, PROVIDENCE, RI 02904
(401) 709-2392
(401) 603-0912
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
ADC00038
RI
Other
Enumeration date
02/11/2015
Last updated
03/03/2015
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