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Organization

COMPREHENSIVE COMMUNITY ACTION, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JUSTINE SANDS (FINANCE DIRECTOR)
(401) 562-2249
Entity
Organization

Contact information

Practice address
191 MACARTHUR BLVD, COVENTRY, RI 02816-7244
(401) 943-1981
Mailing address
311 DORIC AVE, CRANSTON, RI 02910-2903

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
1502
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
709000471
MEDICARE OTHER
RI
05
9000471
RI
Enumeration date
04/04/2012
Last updated
05/08/2024
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