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General NPI Number Information
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NPI Number | 1043337330
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Entity Type | Organization
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Legal Business Name | CORTLAND PLACE HEALTH CENTER, INC
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 06/13/2018
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Provider Practice Location Address
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Address Line | 20 AUSTIN AVENUE
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City | GREENVILLE
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State | RI
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Zip | 02828
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Country | US
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Telephone | 401-949-3880
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Fax | 401-949-4170
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Provider Business Mailing Address
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Address Line | 20 AUSTIN AVENUE
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City | GREENVILLE
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State | RI
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Zip | 02828
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Country | US
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Telephone | 401-949-3880
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Fax | 401-949-4170
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Authorized Official
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Title or Position | OWNER
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Name | MR. NORMAN P AUDINO JR.
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Credential |
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Telephone | 401-949-3880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | ALR01379
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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 | LTC00704
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | RI
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