Provider Demographics
NPI:1982878930
Name:COMMUNITY CARE ALLIANCE EARLY INTERVENTION
Entity Type:Organization
Organization Name:COMMUNITY CARE ALLIANCE EARLY INTERVENTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, EARLY INTERVENTION
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGAW
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:401-235-6015
Mailing Address - Street 1:PO BOX 1700
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-0856
Mailing Address - Country:US
Mailing Address - Phone:401-235-7000
Mailing Address - Fax:401-767-4075
Practice Address - Street 1:245 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3123
Practice Address - Country:US
Practice Address - Phone:401-235-7000
Practice Address - Fax:401-767-4075
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY CARE ALLIANCE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-21
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty