Healthcare Provider Details

I. General information

NPI: 1841433836
Provider Name (Legal Business Name): GREENE ACRES HEALTH CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2009
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2052 PLAINFIELD PIKE
GREENE RI
02827-1908
US

IV. Provider business mailing address

588 PAWTUCKET AVE
PAWTUCKET RI
02860-6057
US

V. Phone/Fax

Practice location:
  • Phone: 401-397-7504
  • Fax: 401-397-2514
Mailing address:
  • Phone: 401-751-3800
  • Fax: 401-751-6350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: KELLY ARNOLD
Title or Position: COO
Credential:
Phone: 401-751-3800