Provider Demographics
NPI:1639273865
Name:GARDEN CITY TREATMENT CENTER, INC
Entity Type:Organization
Organization Name:GARDEN CITY TREATMENT CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLAIM
Authorized Official - Middle Name:T
Authorized Official - Last Name:CREIGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-946-2400
Mailing Address - Street 1:1150 RESERVOIR AVE
Mailing Address - Street 2:#100
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-6068
Mailing Address - Country:US
Mailing Address - Phone:401-946-2400
Mailing Address - Fax:401-946-5862
Practice Address - Street 1:1150 RESERVOIR AVE
Practice Address - Street 2:#100
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-6068
Practice Address - Country:US
Practice Address - Phone:401-946-2400
Practice Address - Fax:401-946-5862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD06288146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, IntermediateGroup - Multi-Specialty