Provider Demographics
NPI:1851170674
Name:BLACKSTONE VALLEY COMMUNITY ACTION PROGRAM, INC.
Entity Type:Organization
Organization Name:BLACKSTONE VALLEY COMMUNITY ACTION PROGRAM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-723-4520
Mailing Address - Street 1:32 GOFF AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-8403
Mailing Address - Country:US
Mailing Address - Phone:401-723-4520
Mailing Address - Fax:
Practice Address - Street 1:32 GOFF AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-8403
Practice Address - Country:US
Practice Address - Phone:401-723-4520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency