DOCKRAY STREET GROUP HOME – NPI #1790810968
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

DOCKRAY STREET GROUP HOME is a community based residential treatment facility located in WAKEFIELD, RI. NPPES has assigned the NPI number 1790810968 to DOCKRAY STREET GROUP HOME on February 21, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for DOCKRAY STREET GROUP HOME below.

NPI Profile for
DOCKRAY STREET GROUP HOME

NPI Number
1790810968
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
DOCKRAY STREET GROUP HOME
Primary location
53 DOCKRAY ST
WAKEFIELD, RI 02879
Phone: (401) 789-5110 Fax:
Mailing address
6 HARRINGTON RD
CRANSTON, RI 02920-3080
Phone: (401) 462-2659 Fax:
Organization Subpart
No
Authorized Official
ELLEN NELSON
DIRECTOR
Phone: (401) 462-6001
Updated
Identifiers

Identifiers for DOCKRAY STREET GROUP HOME

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDRILC01934
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)		 RI 86

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.