Provider Demographics
NPI:1356661102
Name:RHODE ISLAND HOME CARE INC
Entity Type:Organization
Organization Name:RHODE ISLAND HOME CARE INC
Other - Org Name:RHODE ISLAND HOME CARE INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR, CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:G
Authorized Official - Last Name:KULIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-262-5500
Mailing Address - Street 1:222 RESERVOIR AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02907-3430
Mailing Address - Country:US
Mailing Address - Phone:401-262-5500
Mailing Address - Fax:401-262-5531
Practice Address - Street 1:222 RESERVOIR AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02907-3430
Practice Address - Country:US
Practice Address - Phone:401-262-5500
Practice Address - Fax:401-262-5531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINO LICENSE REQUIRED251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI=========Medicaid