Healthcare Provider Details

I. General information

NPI: 1053228106
Provider Name (Legal Business Name): PINE MEADOWS ASSISTED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 SEVEN MILE RD
HOPE RI
02831-1850
US

IV. Provider business mailing address

10 TRIPPS LN
RIVERSIDE RI
02915-3014
US

V. Phone/Fax

Practice location:
  • Phone: 401-654-4096
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: CORISSA BERNIER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 401-654-4074