Provider Demographics
NPI:1093799207
Name:ADULT DAY CENTER OF WESTERLY INC.
Entity Type:Organization
Organization Name:ADULT DAY CENTER OF WESTERLY INC.
Other - Org Name:WESTERLY ADULT DAY SERVICES INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-596-1336
Mailing Address - Street 1:5 UNION ST
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-2131
Mailing Address - Country:US
Mailing Address - Phone:401-596-1336
Mailing Address - Fax:401-596-6186
Practice Address - Street 1:5 UNION ST
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-2131
Practice Address - Country:US
Practice Address - Phone:401-596-1336
Practice Address - Fax:401-596-6186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-01
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI10261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care