Provider Demographics
NPI:1750305405
Name:DIAGNOSTIC EVALUATION INSTITUTE. LLC
Entity Type:Organization
Organization Name:DIAGNOSTIC EVALUATION INSTITUTE. LLC
Other - Org Name:MEADOWS EDGE RECOVERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GISELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:FEMINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-294-6170
Mailing Address - Street 1:580 TEN ROD RD
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-4220
Mailing Address - Country:US
Mailing Address - Phone:401-294-6170
Mailing Address - Fax:401-295-5255
Practice Address - Street 1:580 TEN ROD RD
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4220
Practice Address - Country:US
Practice Address - Phone:401-294-6170
Practice Address - Fax:401-295-5255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI555101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty