NICKERSON COMMUNITY CENTER NPI 1457549578

NPI Information

  • NPI: 1457549578
  • Provider Name: NICKERSON COMMUNITY CENTER
  • Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
  • Entity Type: Organization
  • Address: 97 DELAINE ST
    PROVIDENCE, RI
    ZIP 02909
  • Phone: (401) 383-5672

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NPI Details

NICKERSON COMMUNITY CENTER is a residential treatment facility emotionally disturbed children in Providence, RI. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. NICKERSON COMMUNITY CENTER NPI is 1457549578. The provider is registered as an organization entity type.

The provider's business location address is:

97 DELAINE ST
PROVIDENCE, RI
ZIP 02909-726
Phone: (401) 383-5672

The provider's authorized official is Lisa D'ambra .
The authorized official title is Executive Director and has the following contact phone number (401) 351-2241.

The enumeration date for this NPI number is 10/15/2007 and was last updated on 10/15/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthNo
2322D00000XResidential Treatment Facility, Emotionally Disturbed ChildrenYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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