Provider Demographics
NPI:1720311202
Name:DELTA CONSULTANTS PROVIDENCE/ATTLE INC.
Entity Type:Organization
Organization Name:DELTA CONSULTANTS PROVIDENCE/ATTLE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:401-421-1405
Mailing Address - Street 1:2 REGENCY PLZ
Mailing Address - Street 2:SUITE 12
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-3160
Mailing Address - Country:US
Mailing Address - Phone:401-421-1405
Mailing Address - Fax:401-331-8223
Practice Address - Street 1:2 REGENCY PLZ
Practice Address - Street 2:SUITE 12
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-3160
Practice Address - Country:US
Practice Address - Phone:401-421-1405
Practice Address - Fax:401-331-8223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty