Provider Demographics
NPI:1124585427
Name:UNITED CEREBRAL PALSY OF RHODE ISLAND, INC.
Entity type:Organization
Organization Name:UNITED CEREBRAL PALSY OF RHODE ISLAND, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSSOLARI
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-728-1800
Mailing Address - Street 1:200 MAIN ST STE 210
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4119
Mailing Address - Country:US
Mailing Address - Phone:401-728-1800
Mailing Address - Fax:
Practice Address - Street 1:1 RICHMOND SQ STE 103K
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5166
Practice Address - Country:US
Practice Address - Phone:508-812-0613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-23
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health