Provider Demographics
NPI:1811496664
Name:DIVERSITY ADULT DAY HEALTH CARE CENTER
Entity type:Organization
Organization Name:DIVERSITY ADULT DAY HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:COLIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:HANRAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-427-1337
Mailing Address - Street 1:433 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02907-1766
Mailing Address - Country:US
Mailing Address - Phone:401-427-1337
Mailing Address - Fax:401-369-7818
Practice Address - Street 1:433 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02907-1766
Practice Address - Country:US
Practice Address - Phone:401-427-1337
Practice Address - Fax:401-369-7818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIADC00048261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care