Healthcare Provider Details

I. General information

NPI: 1093786071
Provider Name (Legal Business Name): FRIENDLY HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 12/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 RHODES AVE
WOONSOCKET RI
02895-2899
US

IV. Provider business mailing address

303 RHODES AVE
WOONSOCKET RI
02895-2899
US

V. Phone/Fax

Practice location:
  • Phone: 401-769-7220
  • Fax: 401-766-8282
Mailing address:
  • Phone: 401-769-7220
  • Fax: 401-766-8282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number631
License Number StateRI

VIII. Authorized Official

Name: MS. KATHARINE R EPP
Title or Position: CEO
Credential:
Phone: 401-769-7220