BLUEBERRY LANE GROUP HOME (NPI# 1841335510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841335510 |
| Entity Type | Organization |
| Organization Name | BLUEBERRY LANE GROUP HOME |
| Practice Address |
45 Blueberry Ln N Kingstown RI 02852-1949 |
| Mailing Address |
6 Harrington Rd Cranston RI 02920-3080 |
| Practice Telephone | 4018856488 |
| Mailing Telephone | 4014622659 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. ELLEN R NELSON (DIRECTOR) |
| Authorized Official Telephone | 4014626001 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 191 | RI | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | LC02099 | 05 |
| Street Address |
45 BLUEBERRY LN |
| City | N KINGSTOWN |
| State | RI |
| Zip Code | 02852-1949 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063037059 | Rhode Island Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 4255 Quaker Lane, North Kingstown, RI 02852 | 2020-06-15 |
| 1588216543 | Stop Look & Listen LLC | Counselor | 917 Ten Rod Rd, 917 Ten Rod Rd., North Kingstown, RI 02852 | 2019-07-10 |
| 1841856358 | Carlos Albert Saraiva | Pharmacist | 113 Frenchtown Road, North Kingstown, RI 02852 | 2019-05-10 |
| 1184143851 | Jessica Topitzer | Nurse Practitioner | 426f Scrabbletown Rd., N. Kingstown, RI 02852 | 2017-09-14 |
| 1275074940 | Amanda Kathryn Lennon | Social Worker | 2 Ripple Lane, North Kingstown, RI 02852 | 2017-03-15 |
| 1164975728 | Charlotte Elizabeth Bigg | Dentist | 145 Phillips St, North Kingstown, RI 02852 | 2016-08-01 |
| 1043603913 | Pamela Morelli | Social Worker | 426 Scrabbletown Rd., North Kingstown, RI 02852 | 2015-03-16 |
| 1942691845 | Catherine Cooney | Counselor | 1130 Ten Rod Rd, Ste E305, North Kingstown, RI 02852 | 2015-02-12 |
| 1154753168 | Kenneth N Beaupre | Counselor | 23 Brown St Ste 107, North Kingstown, RI 02852 | 2013-07-31 |
| 1154613909 | Kimberly Micucci | Counselor | 1950 Tower Hill Road, Acute Stabilization Unit, North Kingstown, RI 02852 | 2011-05-12 |
| Find all providers in zip 02852 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336274430 | Stony Lane Group Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 586 Stony Ln, N Kingstown, RI 02852-3703 | 2007-02-22 |
| 1235274721 | Hatchery Road Group Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 317 Hatchery Rd, N Kingstown, RI 02852-4652 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639307176 | Perspectives Corporation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 53 Dockray Street, Wakefield, RI 02879 | 2009-06-23 |
| 1740302082 | Spurwinkri-brook Drive | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10 Brook Dr, Hope Valley, RI 02832-2504 | 2007-04-06 |
| 1275655425 | Spurwink Ri - Crompton Road | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 106 Crompton Rd, East Greenwich, RI 02818-1202 | 2007-04-06 |
| 1699897942 | Spurwink Ri-south County Trail | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2944 S County Trl, East Greenwich, RI 02818-1429 | 2007-04-06 |
| 1700908969 | Spurwink Ri - Peaked Rock Road | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 33 Peaked Rock Rd, Wakefield, RI 02879-2380 | 2007-04-06 |
| 1235251489 | Spurwink Ri - Seven Mile Road | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 569 Seven Mile Rd, Hope, RI 02831-1850 | 2007-04-06 |
| 1467574624 | Spurwink Ri - Plainfield Pike | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1150 Plainfield Pike, Cpu Summit General Store, RI 02827-1904 | 2007-04-06 |
| 1881713733 | Re-focus Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 18 11th St, Providence, RI 02906-2910 | 2007-03-29 |
| 1982723987 | Re-focus Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7 Cooke Dr, North Scituate, RI 02857-1609 | 2007-03-29 |
| 1154440188 | Re-focus Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 179 Bourne St, North Providence, RI 02904-3707 | 2007-03-29 |
| Find all providers with the same taxonomy | ||||
| City | N KINGSTOWN |
| Zip Code | 02852 |
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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.