MEDICARE: SCALABRINI VILLA, INC.

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	LTC00367	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5003	OTHER	RI	BLUE CROSS & BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	71-07104	OTHER	RI	UNITED HEALTHCARE OF NE
4	40-2433	OTHER	RI	BLUE CHIP OF RI
5	71-01149	OTHER	RI	UNITED HEALTH - EVERCARE

General Provider Information

NPI Number	:	1437157898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCALABRINI VILLA, INC.

Provider Business Mailing Address
First Line	:	860 N QUIDNESSETT RD
Second Line	:
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-1000
Country	:	US
Telephone Number	:	401-884-1802
Fax Number	:	401-884-4727

Provider Business Practice Location Address
First Line	:	860 N QUIDNESSETT RD
Second Line	:
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-1000
Country	:	US
Telephone Number	:	401-884-1802
Fax Number	:	401-884-4727

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JOY RYAN
Credential	:
Telephone Number	:	401-884-1802

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	08/03/2007

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Directions to “SCALABRINI VILLA, INC. ” Practice Location

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