Provider Demographics
NPI:1841323094
Name:SSTAR OF RHODE ISLAND, INC.
Entity type:Organization
Organization Name:SSTAR OF RHODE ISLAND, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOUVEIA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-463-6001
Mailing Address - Street 1:386 STANLEY ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-6009
Mailing Address - Country:US
Mailing Address - Phone:508-235-7010
Mailing Address - Fax:508-646-9482
Practice Address - Street 1:80 EAST ST
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-4421
Practice Address - Country:US
Practice Address - Phone:401-463-6001
Practice Address - Fax:401-463-8572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI617.1324500000X
RI617324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility