Provider Demographics
| NPI: | 1437191061 |
|---|---|
| Name: | COMMUNITY CARE ALLIANCE |
| Entity Type: | Organization |
| Organization Name: | COMMUNITY CARE ALLIANCE |
| Other - Org Name: | FORMERLY NRI COMMUNITY SERVICES |
| Other - Org Type: | Other Name |
| Authorized Official - Title/Position: | PRESIDENT/CEO |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | BENEDICT |
| Authorized Official - Middle Name: | F |
| Authorized Official - Last Name: | LESSING |
| Authorized Official - Suffix: | JR |
| Authorized Official - Credentials: | MSW |
| Authorized Official - Phone: | 401-235-7000 |
| Mailing Address - Street 1: | PO BOX 1700 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WOONSOCKET |
| Mailing Address - State: | RI |
| Mailing Address - Zip Code: | 02895-0856 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 401-235-7000 |
| Mailing Address - Fax: | 401-767-9177 |
| Practice Address - Street 1: | 800 CLINTON ST |
| Practice Address - Street 2: | |
| Practice Address - City: | WOONSOCKET |
| Practice Address - State: | RI |
| Practice Address - Zip Code: | 02895-3245 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 401-235-7000 |
| Practice Address - Fax: | 401-767-9177 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-06-11 |
| Last Update Date: | 2019-08-14 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| 171M00000X, 175T00000X, 225400000X, 251300000X, 251B00000X, 251K00000X, 261QM1300X, 324500000X, 405300000X | ||
| RI | 251S00000X, 261QR0405X, 276400000X, 310400000X, 322D00000X | |
| RI | 627 | 261QM0801X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 251S00000X | Agencies | Community/Behavioral Health | Group - Multi-Specialty | |
| No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | Group - Multi-Specialty | |
| No | 175T00000X | Other Service Providers | Peer Specialist | Group - Multi-Specialty | |
| No | 225400000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner | Group - Multi-Specialty | |
| No | 251300000X | Agencies | Local Education Agency (LEA) | Group - Multi-Specialty | |
| No | 251B00000X | Agencies | Case Management | Group - Multi-Specialty | |
| No | 251K00000X | Agencies | Public Health or Welfare | ||
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | |
| No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | |
| No | 276400000X | Hospital Units | Rehabilitation, Substance Use Disorder Unit | Group - Multi-Specialty | |
| No | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | Group - Multi-Specialty | |
| No | 322D00000X | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children | Group - Multi-Specialty | |
| No | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Group - Multi-Specialty | |
| No | 405300000X | Other Service Providers | Prevention Professional | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| RI | NR02178 | Medicaid | |
| RI | NR02172 | Medicaid | |
| RI | NR14021 | Medicaid | |
| RI | 69250 | Other | BLUE CROSS SA |
| RI | CP00408220 | Other | BCHIP SA |
| RI | CR32696 | Medicaid | |
| RI | 259109 | Other | BC MA |
| RI | 1021720 | Other | UBH |
| RI | NR02172 | Medicaid | |
| RI | 69250 | Other | BLUE CROSS SA |
