Organization
EMMA PENDLETON BRADLEY HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAMIE WAKEFIELD CPA (CFO)
(401) 444-5640
Entity
Organization
Contact information
Practice address
1011 VETERANS MEMORIAL PKWY, RIVERSIDE, RI 02915-5061
(401) 444-5640
Mailing address
1011 VETERANS MEMORIAL PKWY, RIVERSIDE, RI 02915-5061
(401) 444-5640
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
HOS00123
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BH06997
—
RI
Enumeration date
04/24/2012
Last updated
04/24/2012
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