Tri-town Substance Abuse Program | |
1126 Hartford Ave Johnston RI 02919-7130 | |
(401) 351-2750 | |
(401) 351-6613 |
Full Name | Tri-town Substance Abuse Program |
---|---|
Speciality | Community/behavioral Health |
Location | 1126 Hartford Ave, Johnston, Rhode Island |
Authorized Official Name and Position | Joseph R Desantis (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 4013512750 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Tri-town Substance Abuse Program 1126 Hartford Ave Johnston RI 02919-7130 Ph: (401) 351-2750 | Tri-town Substance Abuse Program 1126 Hartford Ave Johnston RI 02919-7130 Ph: (401) 351-2750 |
NPI Number | 1053514935 |
---|---|
Provider Enumeration Date | 06/07/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053514935 | NPI | - | NPPES |
TT37326 | Medicaid | RI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 619 (Rhode Island) | Primary |
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