Provider Demographics
NPI:1922148782
Name:ADELINE LAPLANTE MEMORIAL CENTER, INC.
Entity Type:Organization
Organization Name:ADELINE LAPLANTE MEMORIAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:MCDERMOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-789-3081
Mailing Address - Street 1:PO BOX 56
Mailing Address - Street 2:
Mailing Address - City:PEACE DALE
Mailing Address - State:RI
Mailing Address - Zip Code:02883-0056
Mailing Address - Country:US
Mailing Address - Phone:401-789-3081
Mailing Address - Fax:401-782-8481
Practice Address - Street 1:126 WILLARD AVE
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-3165
Practice Address - Country:US
Practice Address - Phone:401-789-3081
Practice Address - Fax:401-782-8481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI35251C00000X
RI251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIAL46715OtherHBTS
RIAL54348OtherWAIVER CONVERSION
RIAL02956OtherMHRH