Provider Demographics
NPI:1457635393
Name:TRI-TOWN ECONOMIC OPPORTUNITY COMMITTEE
Entity Type:Organization
Organization Name:TRI-TOWN ECONOMIC OPPORTUNITY COMMITTEE
Other - Org Name:TRI-TOWN COMMUNITY ACTION AGENCY
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:DESANTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-519-1902
Mailing Address - Street 1:1126 HARTFORD AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-7109
Mailing Address - Country:US
Mailing Address - Phone:401-351-2750
Mailing Address - Fax:401-349-3125
Practice Address - Street 1:1126 HARTFORD AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-7109
Practice Address - Country:US
Practice Address - Phone:401-351-2750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
RITT77363OtherRI MEDICAL ASSISTANCE
RITT37279Medicaid