Broadrock Road Group Home
LBN: Broadrock Road Group Home
Broadrock Road Group Home is an health care organization with primary practice located at 1230 Broad Rock Rd , Peace Dale RI 02879-1851. The organization recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty.
Broadrock Road Group Home can be contacted via phone (401) 789-6880, or through Nelson, Ellen R via phone (401) 462-6001.
Contact Information
Primary practice address
1230 Broad Rock Rd
Peace Dale RI 02879-1851
Phone: (401) 789-6880
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 320900000X | 122 | Rhode Island |
Profile Details
| NPI number | 1821133505 |
|---|---|
| LBN Legal business name | Broadrock Road Group Home |
| DBA Doing business as | |
| Authorized official | Nelson, Ellen R |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 21st, 2007 |
| Last updated | Aug 22nd, 2020 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821133505 | NPPES |
| Rhode Island | MEDICAID | LC02459 |
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