CHILDREN'S SHELTER OF BLACKSTONE VALLEY, INC. (NPI# 1124152392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124152392 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S SHELTER OF BLACKSTONE VALLEY, INC. |
| Practice Address |
15 Gates St Pawtucket RI 02861-3225 |
| Mailing Address |
15 Gates Street Pawtucket RI 02861 |
| Practice Telephone | 4017224626 |
| Practice Fax Number | 4017272967 |
| Mailing Telephone | 4017224626 |
| Mailing Fax Number | 4017272967 |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2007-09-28 |
| Authorized Official Name | MRS. EILEEN F HERNANDEZ (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4017224626 |
| Authorized Official Credential | MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 40 | RI | Residential Treatment Facilities |
| Street Address |
15 GATES ST |
| City | PAWTUCKET |
| State | RI |
| Zip Code | 02861-3225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629525209 | Brianna Laurila | Dietitian, Registered | 541 Cottage Street, Pawtucket, RI 02861 | 2016-09-01 |
| 1790056430 | Matthew J Lavoie | Physician Assistant | 70 Gill Ave., Pawtucket Center, Genesis Health Care, Pawtucket, RI 02861 | 2012-01-25 |
| 1356359293 | Anita N Vasvani | Dentist | 140 Newport Ave, Pawtucket, RI 02861 | 2006-08-04 |
| 1548294408 | Stop and Shop Supermarket Co LLC | Pharmacy | 368398 Cottage Street, Pawtucket, RI 02861 | 2006-07-10 |
| 1154363695 | Levis M Guzman | Internal Medicine | 139 Benefit St, Pawtucket, RI 02861 | 2006-06-11 |
| 1265938179 | Modern Eyes LLC | Optometrist | 145 Newport Ave, Pawtucket, RI 02861 | 2018-04-01 |
| 1942313929 | Abbas Ghorieshi | Dentist | 115 Newport Ave, Pawtucket, RI 02861 | 2006-08-16 |
| 1114499506 | Arts, Sports, and Technology Resource Organization | Poetry Therapist | 175 Coyle Ave, Pawtucket, RI 02861-1007 | 2018-12-22 |
| 1235600255 | Abdoulaye Soumahoro | Driver | 68 Webster St, Pawtucket, RI 02861-1016 | 2018-12-17 |
| 1376761544 | Professional Internal Medicine Associates Inc | Internal Medicine | 139 Benefit St, Pawtucket, RI 02861-1024 | 2007-04-23 |
| Find all providers in zip 02861 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760513600 | Oakmont Community Resources, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 35 Amey St, Pawtucket, RI 02860-1106 | 2007-03-09 |
| 1508997628 | Turning Point | Residential Treatment Facility, Emotionally Disturbed Children | 5 Kids Way, Pawtucket, RI 02860-2206 | 2007-03-08 |
| 1295919900 | Blackstone Valley Youth & Family Collaborative | Residential Treatment Facility, Emotionally Disturbed Children | 209 Cottage St, Pawtucket, RI 02860-3026 | 2007-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407076227 | Youth Services International Holdings | Residential Treatment Facility, Emotionally Disturbed Children | 188 Academy Ave, Providence, RI 02908-4452 | 2007-04-26 |
| 1760606396 | Community Solutions, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 785 Greenville Ave, Johnston House, Johnston, RI 02919-1329 | 2007-04-13 |
| 1508080136 | Community Solutions, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 344 Hopkins Hill Rd, Coventry House, Coventry, RI 02816-6332 | 2007-04-13 |
| 1235259631 | Ocean Tides | Residential Treatment Facility, Emotionally Disturbed Children | 635 Ocean Rd, Narragansett, RI 02882-1314 | 2007-03-30 |
| 1386760536 | Perspectives Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 125 Sand Turn Rd, South Kingstown, RI 02879 | 2007-03-21 |
| 1457484875 | Lighthouse for Youth | Residential Treatment Facility, Emotionally Disturbed Children | 81 Spencer Ct, Wakefield, RI 02879-2820 | 2007-03-14 |
| 1245362185 | Washington Park Citizens Association, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1279 Broad St, Providence, RI 02905-2935 | 2007-03-09 |
| 1881735389 | Justice Resource Institute, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 818 Dyer Ave, Cranston, RI 02920-6714 | 2007-02-09 |
| 1598834673 | Eckerd Youth Alternatives Inc | Residential Treatment Facility, Emotionally Disturbed Children | One Camp E Hun Tee Place, Exeter, RI 02822-1406 | 2006-11-06 |
| 1609818210 | The Providence Center | Residential Treatment Facility, Emotionally Disturbed Children | 90 Plain St, Providence, RI 02903-4817 | 2006-06-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.