Provider Demographics
NPI:1982297479
Name:GERIATRIC CLINICAL SERVICES INC
Entity type:Organization
Organization Name:GERIATRIC CLINICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSOL
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-316-4425
Mailing Address - Street 1:110 SLATER PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02861-3214
Mailing Address - Country:US
Mailing Address - Phone:401-316-4425
Mailing Address - Fax:401-722-2363
Practice Address - Street 1:110 SLATER PARK AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02861-3214
Practice Address - Country:US
Practice Address - Phone:401-316-4425
Practice Address - Fax:401-722-2363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty