1437191061 NPI number — COMMUNITY CARE ALLIANCE

Table of content: (NPI 1437191061)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437191061 NPI number — COMMUNITY CARE ALLIANCE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY CARE ALLIANCE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FORMERLY NRI COMMUNITY SERVICES
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437191061
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/14/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1700
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOONSOCKET
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02895-0856
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-235-7000
Provider Business Mailing Address Fax Number:
401-767-9177

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 CLINTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOONSOCKET
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02895-3245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-235-7000
Provider Business Practice Location Address Fax Number:
401-767-9177
Provider Enumeration Date:
06/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LESSING
Authorized Official First Name:
BENEDICT
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
401-235-7000

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 175T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM0801X , with the licence number: 627 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0405X , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 276400000X , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 310400000X , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 322D00000X , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 324500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 405300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: NR02178 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: NR02172 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: NR14021 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 69250 . This is a "BLUE CROSS SA" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: CP00408220 . This is a "BCHIP SA" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: CR32696 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 259109 . This is a "BC MA" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 1021720 . This is a "UBH" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




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