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SHANNOCK ROAD GROUP HOME
NPI 1912032079
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Wakefield, RI

Active since February 22, 2007
794 SHANNOCK RD, WAKEFIELD, RI 02879(401) 462-7829 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shannock Road Group Home NPPES

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

SHANNOCK ROAD GROUP HOME (NPI 1912032079) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Wakefield, 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

NPI1912032079
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameSHANNOCK ROAD GROUP HOME
Location Address794 SHANNOCK RDWakefield, RI 02879-4756
Mailing Address6 Harrington RdCranston, RI 02920-3080 · (401) 462-2659 · Fax (401) 462-6631
Phone(401) 462-7829
Organization SubpartNo
Authorized OfficialEllen R NelsonDirector · (401) 462-6001
Enumeration DateFebruary 22, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1912032079 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 · 15
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
794 SHANNOCK RD, Wakefield, RI 02879
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Other Identifiers 1

MedicaidLC01922RI

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 Shannock Road Group Home's NPI number?

The NPI number for Shannock Road Group Home is 1912032079. It was assigned to this organization in the NPPES registry on February 22, 2007.

Where is Shannock Road Group Home located?

Shannock Road Group Home is located at 794 Shannock Rd, Wakefield, RI 02879. The listed phone number is (401) 462-7829.

What is Shannock 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 Shannock 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 6 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.