Provider Demographics
NPI:1316308356
Name:THE GRODEN CENTER
Entity type:Organization
Organization Name:THE GRODEN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEFFANIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOZEMPA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:401-274-6310
Mailing Address - Street 1:610 MANTON AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02909-5633
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:610 MANTON AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-5633
Practice Address - Country:US
Practice Address - Phone:401-274-6310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-18
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW01671253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care