Provider Demographics
NPI:1043347602
Name:COMMUNITY CARE ALLIANCE
Entity type:Organization
Organization Name:COMMUNITY CARE ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BENEDICT
Authorized Official - Middle Name:F
Authorized Official - Last Name:LESSING
Authorized Official - Suffix:JR
Authorized Official - Credentials:MSW
Authorized Official - Phone:401-235-6050
Mailing Address - Street 1:PO BOX 1700
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-0856
Mailing Address - Country:US
Mailing Address - Phone:401-235-7000
Mailing Address - Fax:401-767-4075
Practice Address - Street 1:245 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3123
Practice Address - Country:US
Practice Address - Phone:401-235-7000
Practice Address - Fax:401-767-4075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 251B00000X, 251E00000X, 251K00000X, 261QM0801X, 261QM1300X, 261QR0405X, 322D00000X
RI609.1251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed ChildrenGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI29213OtherBCBS EARLY INTERN
RI2094OtherRITE CARE EARLY INTER
RIFR50342Medicaid
RIFR29830Medicaid
RIFR05437Medicaid
RI237628OtherBCBS SUB ABUSE
RIFR02385Medicaid
RI412128OtherBLUE CHIP EARY INTER
RI7497OtherBLUE CHIP BLUE CROSS COUN
RIFR02382Medicaid
RI1021170OtherRITE CARE NHP
RIFR05260Medicaid