Provider Demographics
NPI:1306914692
Name:ROBERTS HEALTH CENTRE, INC.
Entity type:Organization
Organization Name:ROBERTS HEALTH CENTRE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:CATALLOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-294-3587
Mailing Address - Street 1:25 ROBERTS WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-4173
Mailing Address - Country:US
Mailing Address - Phone:401-294-3587
Mailing Address - Fax:401-295-9357
Practice Address - Street 1:25 ROBERTS WAY
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4173
Practice Address - Country:US
Practice Address - Phone:401-294-3587
Practice Address - Fax:401-295-9357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-03
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI00639314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI401523OtherBLUE CHIP
RI4105104Medicaid
RI5067OtherBLUE CROSS
RI4105104Medicaid