Organization
COMPREHENSIVE COMMUNITY ACTION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTINE SANDS (CFO)
(401) 562-2249
Entity
Organization
Contact information
Practice address
30 HOWARD AVE, CRANSTON, RI 02920-3031
(401) 467-9610
Mailing address
311 DORIC AVE, CRANSTON, RI 02910-2903
(401) 562-8305
(401) 467-9030
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000471
—
RI
Enumeration date
01/15/2019
Last updated
05/08/2024
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