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General NPI Number Information
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NPI Number | 1003818063
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Entity Type | Organization
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Legal Business Name | HOPKINS MANOR, LTD.
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Dates
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Enumeration Date | 06/02/2005
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Last Update Date | 07/06/2011
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Provider Practice Location Address
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Address Line | 610 SMITHFIELD ROAD
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02904-3899
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Country | US
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Telephone | 401-353-6300
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Fax | 401-353-8165
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Provider Business Mailing Address
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Address Line | 610 SMITHFIELD ROAD
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02904-3899
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Country | US
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Telephone | 401-353-6300
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Fax | 401-353-8165
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. MARK STEVEN LEVESQUE
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Credential | MS, NHA
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Telephone | 401-353-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 596
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 598
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License Number State | RI
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