Provider Demographics
NPI:1073076121
Name:PARENT SUPPORT NETWORK OF RHODE ISLAND
Entity Type:Organization
Organization Name:PARENT SUPPORT NETWORK OF RHODE ISLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CONLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-467-6855
Mailing Address - Street 1:535 CENTERVILLE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4376
Mailing Address - Country:US
Mailing Address - Phone:401-467-6855
Mailing Address - Fax:
Practice Address - Street 1:535 CENTERVILLE RD STE 202
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4376
Practice Address - Country:US
Practice Address - Phone:401-467-6855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-07
Last Update Date:2019-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty