Provider Demographics
NPI:1275663221
Name:TRI-TOWN ECONOMIC OPPORTUNITY COMMITTEE
Entity Type:Organization
Organization Name:TRI-TOWN ECONOMIC OPPORTUNITY COMMITTEE
Other - Org Name:TRI-TOWN COMMUNITY ACTION AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DESANTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-351-2750
Mailing Address - Street 1:1126 HARTFORD AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-7109
Mailing Address - Country:US
Mailing Address - Phone:401-351-2750
Mailing Address - Fax:401-351-6611
Practice Address - Street 1:715 PUTNAM PIKE
Practice Address - Street 2:ADULT DAY SERVICE BUILDING
Practice Address - City:GREENVILLE
Practice Address - State:RI
Practice Address - Zip Code:02828-1428
Practice Address - Country:US
Practice Address - Phone:401-949-3890
Practice Address - Fax:401-949-5666
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRI-TOWN ECONOMIC OPPORTUNITY COMMITTEE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-07
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI1261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIDC04475Medicaid