Provider Demographics
NPI:1770045742
Name:COMMUNITY RESIDENCES, INC. RHODE ISLAND
Entity type:Organization
Organization Name:COMMUNITY RESIDENCES, INC. RHODE ISLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROSIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-621-7600
Mailing Address - Street 1:COMMUNITY RESIDENCES, INC.
Mailing Address - Street 2:50 ROCKWELL ROAD
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-5526
Mailing Address - Country:US
Mailing Address - Phone:860-621-7600
Mailing Address - Fax:860-620-9846
Practice Address - Street 1:COMMUNITY RESIDENCES, INC. RHODE ISLAND
Practice Address - Street 2:10 DORRANCE STREET, SUITE 706
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-2003
Practice Address - Country:US
Practice Address - Phone:401-519-3727
Practice Address - Fax:860-371-2349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-01
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities