Organization Name: | J.ARTHUR TRUDEAU MEMORIAL CENTER TITUS LANE RESIDENTIAL HOME |
NPI Number: | 1699892844 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BOB TEOLIS (DIRECTOR OF FINANCE) |
Mailing Address: | 3445 Post Rd Warwick |
State: | RI US |
Postal Code: | 028867147 |
Phone Number: | 4017392700 |
Fax Number: | |
NPI Enumeration Date: | 03/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320900000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |