Healthcare Provider Details

I. General information

NPI: 1003897828
Provider Name (Legal Business Name): WOODLAND CONVALESCENT CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 WOODLAND RD
NORTH SMITHFIELD RI
02896-8204
US

IV. Provider business mailing address

70 WOODLAND RD
NORTH SMITHFIELD RI
02896-8204
US

V. Phone/Fax

Practice location:
  • Phone: 401-765-0499
  • Fax: 401-765-1225
Mailing address:
  • Phone: 401-765-0499
  • Fax: 401-765-1225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberLTC00580
License Number StateRI

VIII. Authorized Official

Name: MARY-ANN ABBRUZZI
Title or Position: PRESIDENT/ADMINISTRATOR
Credential:
Phone: 401-765-0499