Organization
OCEAN STATE ACADEMY CRANSTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY JOSEPH CLANCY (DIRECTOR)
(401) 423-4234
Entity
Organization
Contact information
Practice address
1301 ELMWOOD AVE, CRANSTON, RI 02910-2204
(401) 423-4234
Mailing address
285 BLOOMFIELD AVE STE 201, CALDWELL, NJ 07006-5144
(973) 287-6094
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/18/2017
Last updated
06/04/2021
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