Provider Demographics
NPI:1720014442
Name:MEETING STREET CENTER
Entity Type:Organization
Organization Name:MEETING STREET CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-533-9100
Mailing Address - Street 1:1000 EDDY STREET
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905
Mailing Address - Country:US
Mailing Address - Phone:401-533-9100
Mailing Address - Fax:
Practice Address - Street 1:1000 EDDY STREET
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905
Practice Address - Country:US
Practice Address - Phone:401-533-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI2092OtherEI NHPRC NUMBER
RI9009994Medicaid
RIES01788Medicaid
RI4600103OtherSL UHP NUMBER
RI6400144OtherPT/OT UHP NUMBER
RIMS59102Medicaid
RI292177OtherEI BLUE CROSS NUMBER
RI2058OtherSS NHPRC NUMBER
RI412296OtherEI BCHIP NUMBER
RI99947OtherSS BLUE CROSS