Shannock Road Group Home
NPI #1912032079 in Wakefield, Rhode Island
Provider Information
- NPI Number
- 1912032079
- Entity Type
- Organization
- Organization Name
- Shannock Road Group Home
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Feb 22, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 794 SHANNOCK RD
- City
- Wakefield
- State
- Rhode Island
- ZIP Code
- 02879-4756
- Phone
- (401) 462-7829
Authorized Official
- Name
- MS. ELLEN R NELSON
- Title
- DIRECTOR
- Phone
- (401) 462-6001
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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