Organization
PROVIDENCE COMMUNITY ACTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIGNA MARRERO LCDP, RCS (SENIOR ADMINISTRATOR)
(401) 272-0660
Entity
Organization
Contact information
Practice address
662 HARTFORD AVENUE, PROVIDENCE, RI 02909
(401) 272-0660
(401) 454-0195
Mailing address
662 HARTFORD AVENUE, PROVIDENCE, RI 02909
(401) 272-0660
(401) 454-0195
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
615.1
RI
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1021990
BEACON
RI
01
—
303635-5
BLUE CROSS
RI
01
—
410608
BLUE CHIP
RI
05
—
PC12087
—
RI
Enumeration date
10/24/2006
Last updated
10/09/2009
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