| Spurwink Ri | |
|
935 Park Avenue Cranston RI 02910-2012 | |
| (401) 781-4380 | |
| Not Available |
| Full Name | Spurwink Ri |
|---|---|
| Speciality | Day Training, Developmentally Disabled Services |
| Location | 935 Park Avenue, Cranston, Rhode Island |
| Authorized Official Name and Position | Raymond A Arsenault (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4017814380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spurwink Ri One Spurwink Place Cranston RI 02910-2012 Ph: (401) 781-4380 | Spurwink Ri 935 Park Avenue Cranston RI 02910-2012 Ph: (401) 781-4380 |
| NPI Number | 1548217805 |
|---|---|
| Provider Enumeration Date | 05/30/2006 |
| Last Update Date | 08/07/2011 |
| Medicare PECOS PAC ID | 7012099021 |
|---|---|
| Medicare Enrollment ID | O20080130000260 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548217805 | NPI | - | NPPES |
| SR54944 | Medicaid | RI | |
| 166 | Other | RI | MHRH DDD |
| SR54372 | Medicaid | RI | |
| L9145 | Medicaid | RI |
| Provider Name | Michael Hansen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518144351 PECOS PAC ID: 6608958632 Enrollment ID: I20080130000393 |
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