Provider Demographics
NPI:1346441045
Name:TRI-TOWN ECONOMIC OPPORTUNITY COUNCIL
Entity Type:Organization
Organization Name:TRI-TOWN ECONOMIC OPPORTUNITY COUNCIL
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:SUITE 209
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-7130
Mailing Address - Country:US
Mailing Address - Phone:401-351-2750
Mailing Address - Fax:401-351-3125
Practice Address - Street 1:1126 HARTFORD AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-7130
Practice Address - Country:US
Practice Address - Phone:401-351-2750
Practice Address - Fax:401-351-3125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
RITT32729Medicaid