1. Home
  2. Directory
  3. Rhode Island
  4. Peace Dale
  5. Community Based Residential Treatment Facility Intellectual And Or Developmental Disabilities
  6. NPI Profile

BROADROCK ROAD GROUP HOME
NPI 1821133505
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Peace Dale, RI

Active since February 21, 2007
1230 BROAD ROCK RD, PEACE DALE, RI 02879(401) 789-6880 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Broadrock Road Group Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROADROCK ROAD GROUP HOME (NPI 1821133505) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Peace Dale, Rhode Island and active in the NPI registry since February 2007. The organization lists Ellen R Nelson, Director, as its authorized official.

NPPES Registry Identity

NPI1821133505
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameBROADROCK ROAD GROUP HOME
Location Address1230 BROAD ROCK RDPeace Dale, RI 02879-1851
Mailing Address6 Harrington RdCranston, RI 02920-3080
Phone(401) 789-6880
Organization SubpartNo
Authorized OfficialEllen R NelsonDirector · (401) 462-6001
Enumeration DateFebruary 21, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1821133505 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
License✔ Licensed in RI · 122
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
1230 BROAD ROCK RD, Peace Dale, RI 02879
Open in Google Maps ↗

Other Identifiers 1

MedicaidLC02459RI

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Broadrock Road Group Home's NPI number?

The NPI number for Broadrock Road Group Home is 1821133505. It was assigned to this organization in the NPPES registry on February 21, 2007.

Where is Broadrock Road Group Home located?

Broadrock Road Group Home is located at 1230 Broad Rock Rd, Peace Dale, RI 02879. The listed phone number is (401) 789-6880.

What is Broadrock Road Group Home's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Broadrock Road Group Home was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.