| The Providence Community Health Centers, Inc. | |
|
375 Allens Ave Providence RI 02905-5010 | |
| (401) 444-0400 | |
| (401) 444-0468 |
| Full Name | The Providence Community Health Centers, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 375 Allens Ave, Providence, Rhode Island |
| Authorized Official Name and Position | Kevin Cabral (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4014440400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Providence Community Health Centers, Inc. 375 Allens Ave Providence RI 02905-5010 Ph: (401) 444-0400 | The Providence Community Health Centers, Inc. 375 Allens Ave Providence RI 02905-5010 Ph: (401) 444-0400 |
| NPI Number | 1891775128 |
|---|---|
| Provider Enumeration Date | 01/20/2006 |
| Last Update Date | 12/05/2024 |
| Certification Date | 12/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891775128 | NPI | - | NPPES |
| 7001361 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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