Active NPI
Community Connect Ri LLC
- Peer Specialist
- Pawtucket, RI
National Provider Identifier
1639082159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Legal business name
- COMMUNITY CONNECT RI LLC
- Practice address
- 560 Mineral Spring Ave
Pawtucket, RI 02860-3363 - Phone
- (401) 696-7090
- NPI assigned
- Sep 25, 2026
- Last updated
- Sep 25, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Zdahmond Dale, CPRS
- Title
- Owner / Authorized Official
- Phone
- (401) 696-7090
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | NU | Primary |
Addresses
Primary practice location
560 Mineral Spring Ave
Pawtucket, RI 02860-3363
Mailing address
560 Mineral Spring Ave
Pawtucket, RI 02860-3363
Phone (401) 696-7090
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790294400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790294400000",
"number": "1639082159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "560 MINERAL SPRING AVE",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028603363",
"telephone_number": "401-696-7090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 MINERAL SPRING AVE",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028603363",
"telephone_number": "401-696-7090"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COMMUNITY CONNECT RI LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-25",
"last_updated": "2026-09-25",
"certification_date": "2026-09-25",
"status": "A",
"authorized_official_last_name": "DALE",
"authorized_official_first_name": "ZDAHMOND",
"authorized_official_title_or_position": "OWNER / AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "401-696-7090",
"authorized_official_credential": "CPRS"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.