Organization
EAST BAY COMMUNITY ACTION PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RILWAN FEYISITAN (CEO)
(401) 848-6697
Entity
Organization
Contact information
Practice address
19 BROADWAY, NEWPORT, RI 02840-2937
(401) 848-6697
(401) 847-6220
Mailing address
19 BROADWAY, NEWPORT, RI 02840-2937
(401) 848-6697
(401) 847-6220
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
01520
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EB51407
—
RI
Enumeration date
05/31/2006
Last updated
03/11/2025
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