Provider Demographics
NPI: | 1790001840 |
---|---|
Name: | SEVEN HILLS RHODE ISLAND INC |
Entity type: | Organization |
Organization Name: | SEVEN HILLS RHODE ISLAND INC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | VICE PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MARISSA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | RUFF |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MS |
Authorized Official - Phone: | 401-597-6700 |
Mailing Address - Street 1: | 80 FABIEN STREET |
Mailing Address - Street 2: | |
Mailing Address - City: | WOONSOCKET |
Mailing Address - State: | RI |
Mailing Address - Zip Code: | 02895 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 401-597-6700 |
Mailing Address - Fax: | 401-597-6706 |
Practice Address - Street 1: | 80 FABIEN STREET |
Practice Address - Street 2: | |
Practice Address - City: | WOONSOCKET |
Practice Address - State: | RI |
Practice Address - Zip Code: | 02895 |
Practice Address - Country: | US |
Practice Address - Phone: | 401-597-6700 |
Practice Address - Fax: | 401-597-6706 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-04-14 |
Last Update Date: | 2023-07-27 |
Deactivation Date: | 2023-04-21 |
Deactivation Code: | |
Reactivation Date: | 2023-07-26 |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 253Z00000X | Agencies | In Home Supportive Care |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
RI | TH80988 | Medicaid |