Comprehensive Community Action, Inc
Organization Active NPI Community/Behavioral Health Agency · Cranston, RI
NPI 1770849259 · NPPES record last updated May 8, 2024
Key facts
- NPI
- 1770849259
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- 1502 (RI)
- Legal business name
- COMPREHENSIVE COMMUNITY ACTION, INC
- Practice address
- 311 Doric Ave
Cranston, RI 02910-2903 - Phone
- (401) 467-9610
- NPI assigned
- Apr 9, 2012
- Organization subpart
- No
Authorized official
- Name
- Kevin S Cote, CPA
- Title
- Finance Director
- Phone
- (401) 562-2250
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 6
Practitioners 26
-
Iehsus S Flores-Perez, M.D.
-
Atsuko Hirae, NP
-
Elena M Kwetkowski, D.O.
-
Julie Ann Lemaire, FNP
-
Moira L Long, DNP, MSN, FNP-C
-
Arthur Ronald Taylor, CAPRN
-
Diego A. Tecun, NP
-
Danielle Crowell, APRN
-
Shawna Bell, LMHC
-
Donna M. Deangelis, LICSW
-
Aileen Marie Gonzalez, DNP, PMHNP-BC
-
Christopher Hicks, PMHNP
-
Crystal L Martinez, MSW
-
Rodrigo Nardi, M.D.
-
Suzanne Marie Raposa, LICSW, MSW
-
Sandra Salamanca, PHYSICIAN ASSISTANT
-
Kristen A Stewart, R.N.P.
-
Kimberly M. Stokinger, PA-C
-
Ketia Turenne, RN
-
Megan Lynn Vebber, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
Federally qualified health center certification: CCN 411840
- Legal name
- COMPREHENSIVE COMMUNITY ACTION, INC.
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jul 14, 2008
- Last certification
- Jul 14, 2008
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Dec 7, 1967 in RI
- Enrollment address
- 311 Doric Ave
Cranston, RI 29102903
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Joanne M McGunagle |
Corporate Director |
Mar 8, 2004 | 100% |
| Marcia a Lopresti |
Corporate Officer |
Jul 1, 2006 | 9% |
| John N Bucci |
Corporate Officer |
Jul 1, 2001 | 9% |
| Jason P Bouchard |
Corporate Officer |
Jul 1, 2008 | 9% |
| Marybeth Corrente |
Corporate Officer |
Jul 1, 1996 | 9% |
| Marjorie C Barrett |
Corporate Officer |
Jul 1, 2006 | 9% |
| Margaret M Long |
Corporate Officer |
Jul 1, 2001 | 9% |
| Michelle P Davis |
Corporate Officer |
Jul 1, 2011 | 9% |
| William E Walsh |
Corporate Director |
Feb 10, 2004 | 100% |
| W-2 Managing Employee | Feb 10, 2004 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140610000839 | RI | Part a Provider - Federally Qualified Health Center (FQHC) | 0749176055 | Practice locations: Cranston, RI |
National Provider Directory
- Tax ID family
- Comprehensive Comm Acti
Locations
848 Atwood Ave
Cranston, RI 02920
30 Howard Ave
Cranston, RI 02920
Phone (401) 467-9610
226 Buttonwoods Ave
Warwick, RI 02886
Phone (401) 467-9610
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 1502 | RI | Yes |
Addresses
Primary practice location
311 Doric Ave
Cranston, RI 02910-2903
Mailing address
311 Doric Ave
Cranston, RI 02910-2903
Phone (401) 467-9610
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9000471 | Medicaid | RI | |
| 709000471 | Other | MEDICARE OTHER |
Other providers in Cranston, RI
- Coia Comprehensive Primary Care LLC
- Michelle Ann Collette
- Gianna Comparone
- Comprehensive Community Action, Inc
- Comprehensive Community Action, Inc
- Comprehensive Community Action, Inc
- Comprehensive Community Action, Inc.
- Comprehensive Home Medical Equipment Inc
- Comprehensive OB/GYN Care, Inc
- John Concannon
All providers in Cranston, RI · Community/Behavioral Health Agency in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.