Organization
DEPARTMENT OF VETERANS AFFAIRS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN JAMES BOUCHER (REGISTERED NURSE)
(401) 273-7100
Entity
Organization
Contact information
Practice address
860 CHALKSTONE AVE, PROVIDENCE, RI 02902-0001
(401) 273-7100
Mailing address
860 CHALKSTONE AVE, PROVIDENCE, RI 02902-0001
(401) 273-7100
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
RN38791
RI
Other
Enumeration date
07/03/2008
Last updated
07/03/2008
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