NPIMap

Organization Active NPI

J.Arthur Trudeau Memorial Center Spring Grove Residential Home

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Warwick, RI
National Provider Identifier
1689791832
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
J.ARTHUR TRUDEAU MEMORIAL CENTER SPRING GROVE RESIDENTIAL HOME
Practice address
3445 Post Rd
Warwick, RI 02886-7147
Phone
(401) 739-2700
NPI assigned
Mar 23, 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
Bob Teolis
Title
Director of Finance
Phone
(401) 739-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

3445 Post Rd
Warwick, RI 02886-7147

Mailing address

3445 Post Rd
Warwick, RI 02886-7147

Other identifiers 1

IdentifierTypeStateIssuer
KC60070MedicaidRI

National Provider Directory

National Provider Directory
Tax ID family
J Arthur Trudeau Memorial Center18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689791832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 POST RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028867147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 POST RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028867147",
            "telephone_number": "401-739-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J.ARTHUR TRUDEAU MEMORIAL CENTER SPRING GROVE RESIDENTIAL HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TEOLIS",
        "authorized_official_first_name": "BOB",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "401-739-2700"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "KC60070",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, 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.