Healthcare Provider Details

I. General information

NPI: 1437458684
Provider Name (Legal Business Name): ASLC OPCO RI I, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2011
Last Update Date: 05/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 SAINT JOSEPH ST
WOONSOCKET RI
02895-5416
US

IV. Provider business mailing address

620 MAIN ST 3B
EAST GREENWICH RI
02818-3673
US

V. Phone/Fax

Practice location:
  • Phone: 401-765-5844
  • Fax: 401-765-1026
Mailing address:
  • Phone: 401-398-7131
  • Fax: 401-398-7313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberLTC00766
License Number StateRI

VIII. Authorized Official

Name: MR. JEFFREY ALEXANDER BARNHILL
Title or Position: EVP/CFO
Credential:
Phone: 401-398-7131