Healthcare Provider Details

I. General information

NPI: 1184947954
Provider Name (Legal Business Name): HEALTHCARE OF RHODE ISLAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2010
Last Update Date: 03/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 S COUNTY COMMONS WAY BLDG. 6 E 3 REAR
SOUTH KINGSTOWN RI
02879-2296
US

IV. Provider business mailing address

50 S COUNTY COMMONS WAY BLDG. 6 E 3 REAR
SOUTH KINGSTOWN RI
02879-2296
US

V. Phone/Fax

Practice location:
  • Phone: 401-284-2555
  • Fax: 401-284-1181
Mailing address:
  • Phone: 401-284-2555
  • Fax: 401-284-1181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberNPA00105
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberNPA00105
License Number StateRI

VIII. Authorized Official

Name: DONNA KENNEDY
Title or Position: PRESIENDT/OWNER
Credential:
Phone: 401-284-2555