Organization
SOUTH ROAD GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELLEN R NELSON (DIRECTOR)
(401) 462-6001
Entity
Organization
Contact information
Practice address
1425 SOUTH RD, WAKEFIELD, RI 02879-7640
(401) 782-9463
Mailing address
6 HARRINGTON RD, CRANSTON, RI 02920-3080
(401) 462-2659
(401) 462-6631
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
16
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LC02538
—
RI
Enumeration date
02/22/2007
Last updated
08/22/2020
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