Organization
THE PROVIDENCE COMMUNITY HEALTH CENTERS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN CABRAL (CFO)
(401) 444-0400
Entity
Organization
Contact information
Practice address
375 ALLENS AVE, PROVIDENCE, RI 02905-5010
(401) 444-0400
(401) 444-0468
Mailing address
375 ALLENS AVE, PROVIDENCE, RI 02905-5010
(401) 444-0400
(401) 444-0468
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7001361
—
RI
Enumeration date
08/15/2005
Last updated
12/05/2024
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