Organization
WHITMARSH CORPORATION
Active
Other names
Whitmarsh House
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT M LAROCCO LMFT (CEO)
(401) 351-7230
Entity
Organization
Contact information
Practice address
1055 N MAIN ST, PROVIDENCE, RI 02904-5718
(401) 351-7230
(401) 421-0198
Mailing address
1055 N MAIN ST, PROVIDENCE, RI 02904-5718
(401) 351-7230
(401) 421-0198
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
404
RI
251S00000X
Community/Behavioral Health Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WC70315
MEDICAID PROVIDER ID
RI
Enumeration date
06/22/2011
Last updated
03/06/2020
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