Provider Demographics
NPI:1841418530
Name:CHILD CARE CONNECTION INC.
Entity Type:Organization
Organization Name:CHILD CARE CONNECTION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MARYBETH
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-334-0100
Mailing Address - Street 1:25 BLACKSTONE VALLEY PL
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-1163
Mailing Address - Country:US
Mailing Address - Phone:401-334-0100
Mailing Address - Fax:401-335-4494
Practice Address - Street 1:25 BLACKSTONE VALLEY PL
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-1163
Practice Address - Country:US
Practice Address - Phone:401-334-0100
Practice Address - Fax:401-335-4494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICC51383Medicaid