Provider Demographics
NPI:1386769529
Name:TRAINING THRU PLACEMENT INCE RESPITE SVS
Entity type:Organization
Organization Name:TRAINING THRU PLACEMENT INCE RESPITE SVS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAPOBIANCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-353-0220
Mailing Address - Street 1:20 MARBLEHEAD AVENUE
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-4248
Mailing Address - Country:US
Mailing Address - Phone:401-353-0224
Mailing Address - Fax:401-353-0225
Practice Address - Street 1:20 MARBLEHEAD AVENUE
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-4248
Practice Address - Country:US
Practice Address - Phone:401-353-0224
Practice Address - Fax:401-353-0225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TT07044Medicare UPIN
TT49034Medicare UPIN