NPIMap

Organization Active NPI

Blackstone Health, Inc

  • Adult Day Care Clinic/Center
  • Pawtucket, RI
National Provider Identifier
1467583534
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
13 Issued in RI
Legal business name
BLACKSTONE HEALTH, INC
Practice address
426 Main St
Pawtucket, RI 02860-2912
Phone
(401) 727-0950
Fax
(401) 725-3053
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Thomas Gough
Title
Executive Director
Phone
(401) 727-0950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 13 RI Primary

Addresses

Primary practice location

426 Main St
Pawtucket, RI 02860-2912

Mailing address

426 Main St
Pawtucket, RI 02860-2912
Phone (401) 727-0950

Other identifiers 1

IdentifierTypeStateIssuer
13OtherRISTATE LICENSE

Other names 1

  • New Horizons Adult Day Center Doing business as

National Provider Directory

National Provider Directory

Locations

426 Main St
Pawtucket, RI 02860
Phone (401) 727-0950

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467583534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 MAIN ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028602912",
            "telephone_number": "401-727-0950",
            "fax_number": "401-725-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 MAIN ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028602912",
            "telephone_number": "401-727-0950",
            "fax_number": "401-725-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKSTONE HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOUGH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "401-727-0950",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "RI",
            "license": "13",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "13",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Horizons Adult Day Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pawtucket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.