Provider Demographics
NPI:1386374015
Name:JUSTICE ASSISTANCE
Entity type:Organization
Organization Name:JUSTICE ASSISTANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:DALOMBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-781-7000
Mailing Address - Street 1:1540 PONTIAC AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-4472
Mailing Address - Country:US
Mailing Address - Phone:401-781-7000
Mailing Address - Fax:
Practice Address - Street 1:1540 PONTIAC AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-4472
Practice Address - Country:US
Practice Address - Phone:401-781-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-15
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIISW02960OtherRHODE ISLAND DEPARTMENT OF HEALTH