Organization
CRANSTON ARC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAT COPPAGE (FINANCIAL DIRECTOR)
(401) 941-1112
Entity
Organization
Contact information
Practice address
136 CONCORD AVE, CRANSTON, RI 02910-3304
(401) 941-1112
(401) 941-2516
Mailing address
111 COMSTOCK PKWY, CRANSTON, RI 02921-2002
(401) 941-1112
(401) 941-2516
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
30
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA02794
EDS PROVIDER NUMBER
RI
Enumeration date
03/08/2007
Last updated
08/22/2020
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