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Organization

THE PROVIDENCE CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CARLA SOSA (CREDENTIALING SPECIALIST)
(401) 921-7386
Entity
Organization

Contact information

Practice address
90 PLAIN ST, PROVIDENCE, RI 02903-4817
(401) 528-0050
Mailing address
171 SERVICE AVE FL 2, WARWICK, RI 02886-1015
(401) 921-7386

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
631.8
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1021730
BEACON
RI
01
23770
BLUE CROSS
RI
01
410282
BLUE CHIP
RI
01
50-64724
UNITED BEHAVIORAL HEALTH
RI
05
PC02213
RI
Enumeration date
06/11/2006
Last updated
03/25/2026
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