Provider Demographics
NPI:1245362185
Name:WASHINGTON PARK CITIZENS ASSOCIATION, INC.
Entity type:Organization
Organization Name:WASHINGTON PARK CITIZENS ASSOCIATION, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:P
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-461-6650
Mailing Address - Street 1:42 JILLSON ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-2904
Mailing Address - Country:US
Mailing Address - Phone:401-461-6650
Mailing Address - Fax:401-781-5262
Practice Address - Street 1:1279 BROAD ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-2935
Practice Address - Country:US
Practice Address - Phone:401-461-6650
Practice Address - Fax:401-781-5262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI43530322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIWP03247OtherRESIDENTIAL CHILD SHEL