Nickerson Community Center
NPI #1457549578 in Providence, Rhode Island
Provider Information
- NPI Number
- 1457549578
- Entity Type
- Organization
- Organization Name
- Nickerson Community Center
- Primary Specialty
- Residential Treatment Facility, Emotionally Disturbed Children
- Enumeration Date
- Oct 15, 2007
- Last Updated
- Oct 15, 2007
Practice Location
- Address
- 97 DELAINE ST
- City
- Providence
- State
- Rhode Island
- ZIP Code
- 02909-2726
- Phone
- (401) 383-5672
Authorized Official
- Name
- LISA D'AMBRA
- Title
- EXECUTIVE DIRECTOR
- Phone
- (401) 351-2241
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
| Residential Treatment Facility, Emotionally Disturbed Children |
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