KEY PROGRAM, INC. (NPI# 1649395583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649395583 |
| Entity Type | Organization |
| Organization Name | KEY PROGRAM, INC. |
| Practice Address |
623 Atwells Ave Suite 201-d Providence RI 02909-7403 |
| Mailing Address |
670 Old Connecticut Path Framingham MA 01701-4548 |
| Practice Telephone | 4018612680 |
| Practice Fax Number | 4017516641 |
| Mailing Telephone | 5088773690 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. MARCIA ALLEN (ADMINISTRATIVE SUPERVISOR) |
| Authorized Official Telephone | 4018612680 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 251S00000X | Community/Behavioral Health | RI | Agencies | |
| X | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | RI | Residential Treatment Facilities |
| Street Address |
623 ATWELLS AVE SUITE 201-D |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02909-7403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235230640 | Kim Marie Medeiros | Counselor | 623 Atwells Ave, Providence, RI 02909-7403 | 2006-09-26 |
| 1689287039 | Sara Hafeez | Optometrist | 623 Atwells Ave, Providence, RI 02909-7403 | 2020-08-26 |
| 1144846478 | Brett Zerbinopoulos | Optometrist | 623 Atwells Ave, Providence, RI 02909-7403 | 2020-06-23 |
| 1609438902 | Brittney Eileen Schieber | Optometrist | 623 Atwells Ave, Providence, RI 02909-7403 | 2019-07-08 |
| 1578129078 | Hyder Jamal Almosawy | Optometrist | 623 Atwells Ave, Providence, RI 02909-7403 | 2019-05-10 |
| 1881172419 | Justin Roberts | Optometrist | 623 Atwells Ave, Providence, RI 02909-7403 | 2018-08-06 |
| 1811475536 | Zachary Gene Walburg | Optometrist | 623 Atwells Ave, Providence, RI 02909-7403 | 2018-08-03 |
| 1366920084 | Joyce Nidal Rached | Optometrist | 623 Atwells Ave, Providence, RI 02909-7403 | 2018-08-03 |
| 1407332166 | Julia Marie Gangloff | Audiologist | 623 Atwells Ave, Providence, RI 02909-7403 | 2018-07-16 |
| 1780107607 | Sarah Wise | Optometrist | 623 Atwells Ave, Providence, RI 02909-7403 | 2017-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578021754 | Roberta Bellas Portugal | Registered Nurse | Behave Care, 188 Valley St, Providence, RI 02909 | 2019-03-07 |
| 1912137324 | Catherine Elaine Tuttle | Social Worker | 623 Atwells Avenue, Suite 201, Providence, RI 02909 | 2009-07-20 |
| 1477736452 | City Dental, LLC | Dentist | 314f Pocasset Avenue, Providence, RI 02909 | 2007-12-12 |
| 1245449651 | Walter R. Vandyck | Occupational Therapist | Springfield Middle School, Providene School Department, 152 Springfield St, Providence, RI 02909 | 2007-05-22 |
| 1780805283 | Marcel A Trisvan | Counselor | Codac Providence, 349 Huntington Ave, Providence, RI 02909 | 2007-05-01 |
| 1215153945 | Codac Inc | Peer Specialist | 349 Huntington Ave, Codac Providence, Providence, RI 02909 | 2007-04-18 |
| 1316076342 | Mulak Chiropractic Center Inc | Chiropractor | 411 Broadway, Providence, RI 02909 | 2007-03-05 |
| 1710042742 | Michael Antonio Pensa | Chiropractor | 45 Eagle St Bld J Unit 100, Providence, RI 02909 | 2006-12-27 |
| 1780768234 | Providence Community Action | Case Management | 662 Hartford Avenue, Providence, RI 02909 | 2006-10-24 |
| 1881629608 | Cora Brigid Mayer | Counselor | 623 Atwells Ave., Communities for People, Inc., Providence, RI 02909 | 2006-07-11 |
| Find all providers in zip 02909 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002006 | East Side Psychotherapy, Inc. | Community/Behavioral Health | 205 Waterman St # 201, Providence, RI 02906-4313 | 2020-10-28 |
| 1336677541 | Theadore Perry | Community/Behavioral Health | 251 Indiana Ave, Providence, RI 02905-2822 | 2017-06-01 |
| 1255863387 | Ludmyr Merlain | Community/Behavioral Health | 52 Felix St, Providence, RI 02908-4837 | 2017-03-29 |
| 1922478056 | Clear Recovery of Cache Valley | Community/Behavioral Health | 277 N Spring Creek Pkwy, Providence, UT 84332-9775 | 2015-10-01 |
| 1992053896 | Harbor House | Community/Behavioral Health | 12 Bassett St, Providence, RI 02903-4206 | 2012-08-27 |
| 1578859179 | Whitmarsh Corporation | Community/Behavioral Health | 1055 N Main St, Providence, RI 02904-5718 | 2011-06-22 |
| 1528352424 | Capital City | Community/Behavioral Health | 25 Danforth St, Providence, RI 02908-3610 | 2011-06-08 |
| 1295028272 | The Genesis Center | Community/Behavioral Health | 620 Potters Ave, Providence, RI 02907-2931 | 2011-05-24 |
| 1568608461 | Adoption Rhode Island | Community/Behavioral Health | 2 Bradford St, Providence, RI 02903-1092 | 2008-12-23 |
| 1457549578 | Nickerson Community Center | Community/Behavioral Health | 97 Delaine St, Providence, RI 02909-2726 | 2007-10-15 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02909 |
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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.