Healthcare Provider Details

I. General information

NPI: 1639190796
Provider Name (Legal Business Name): QUALITY GERONTOLOGICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 02/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 EBEN BROWN LN
CENTRAL FALLS RI
02863-1409
US

IV. Provider business mailing address

60 EBEN BROWN LN
CENTRAL FALLS RI
02863-1409
US

V. Phone/Fax

Practice location:
  • Phone: 401-722-6000
  • Fax: 401-726-0850
Mailing address:
  • Phone: 401-722-6000
  • Fax: 401-726-0850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number685
License Number StateRI

VIII. Authorized Official

Name: MR. CHAD HARRIS SR.
Title or Position: ADMINISTRATOR
Credential: N.H.A.
Phone: 401-722-6000