MEDICARE: HOPKINS MANOR, LTD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	596	RI
2	314000000X	Skilled Nursing Facility	598	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003818063
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPKINS MANOR, LTD.

Provider Business Mailing Address
First Line	:	610 SMITHFIELD ROAD
Second Line	:
City	:	NORTH PROVIDENCE
State	:	RI
Zip	:	02904-3899
Country	:	US
Telephone Number	:	401-353-6300
Fax Number	:	401-353-8165

Provider Business Practice Location Address
First Line	:	610 SMITHFIELD ROAD
Second Line	:
City	:	NORTH PROVIDENCE
State	:	RI
Zip	:	02904-3899
Country	:	US
Telephone Number	:	401-353-6300
Fax Number	:	401-353-8165

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. MARK STEVEN LEVESQUE
Credential	:	MS, NHA
Telephone Number	:	401-353-6300

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	07/06/2011

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Directions to “HOPKINS MANOR, LTD. ” Practice Location

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