NPIMap

East Bay Community Action Program

Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Riverside, RI

NPI 1487916136 · NPPES record last updated Mar 23, 2024

Key facts

NPI
1487916136
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Legal business name
EAST BAY COMMUNITY ACTION PROGRAM
Practice address
610 Wampanoag TRL
Riverside, RI 02915-1504
Phone
(401) 437-1008
Fax
(401) 433-3042
NPI assigned
Jun 8, 2012
Organization subpart
No

Authorized official

Name
Rilwan Feyisitan
Title
Ceo
Phone
(401) 437-1008

Corporate family (same tax ID) 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 30

National Provider Directory

Tax ID family
New Visions for Newport (5 organizations share this tax ID)

Locations

6 John H Chafee Blvd
Newport, RI 02840
Phone (401) 239-1208

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist
Group: 193200000X MULTI-SPECIALTY GROUP		 175T00000X
Community/Behavioral Health Agency 251S00000X RI
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X RI Yes
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X RI

Addresses

Primary practice location

610 Wampanoag TRL
Riverside, RI 02915-1504

Mailing address

100 Bullocks Point
Riverside, RI 02915
Phone (401) 437-1008

Other identifiers

IdentifierTypeStateIssuer
EA1247MedicaidRI

Other names

  • East Bay Behavioral Health Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 23, 2024.

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711152000000",
    "number": "1487916136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BULLOCKS POINT",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "02915",
            "telephone_number": "401-437-1008",
            "fax_number": "401-433-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 WAMPANOAG TRL",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029151504",
            "telephone_number": "401-437-1008",
            "fax_number": "401-433-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY COMMUNITY ACTION PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-08",
        "last_updated": "2024-03-23",
        "certification_date": "2024-03-23",
        "status": "A",
        "authorized_official_last_name": "FEYISITAN",
        "authorized_official_first_name": "RILWAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "401-437-1008"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "RI",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "RI",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "RI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EA1247",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Bay Behavioral Health",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "East Bay Behavioral Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Riverside, RI

All providers in Riverside, RI · Mental Health Clinic/Center (Including Community Mental Health Center) in Rhode Island

Sources for this page

Verify at the official NPI Registry.