Organization
PROSPECT CHARTERCARE SJHSRI, LLC
Active
Other names
St. Joseph Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JON ELDERS (SECRETARY)
(714) 788-1249
Entity
Organization
Contact information
Practice address
200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI 02904-5113
(401) 456-3000
(401) 456-3028
Mailing address
200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI 02904-5113
(401) 456-3000
(401) 456-3028
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
HOS00110
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41S0005
—
RI
Enumeration date
02/27/2014
Last updated
01/15/2021
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