Provider Demographics
NPI:1932503448
Name:UNITED CEREBRAL PALSY OF RHODE ISLAND, INC.
Entity Type:Organization
Organization Name:UNITED CEREBRAL PALSY OF RHODE ISLAND, INC.
Other - Org Name:LIFE WITHOUT LIMITS HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE, CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:
Authorized Official - Last Name:PROVOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-728-1800
Mailing Address - Street 1:200 MAIN ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4131
Mailing Address - Country:US
Mailing Address - Phone:401-728-1800
Mailing Address - Fax:401-728-0182
Practice Address - Street 1:200 MAIN ST
Practice Address - Street 2:SUITE 210
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4131
Practice Address - Country:US
Practice Address - Phone:401-728-1800
Practice Address - Fax:401-728-0182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-13
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIHCP02451251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIHCP02451Medicaid