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General NPI Number Information
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NPI Number | 1114873973
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Entity Type | Organization
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Legal Business Name | OPCO RI EAST PROVIDENCE-1440 WAMPANOAG LLC
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Dates
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Enumeration Date | 03/05/2026
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 1440 WAMPANOAG TRAIL
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City | RIVERSIDE
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State | RI
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Zip | 02915-1045
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Country | US
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Telephone | 401-648-4971
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Fax |
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Provider Business Mailing Address
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Address Line | 303 INTERNATIONAL CIRCLE SUITE 200
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City | HUNT VALLEY
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State | MD
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Zip | 21030
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF ACCOUNTING & FINANCING
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Name | MR. THOMAS J SEXTON
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Credential | CPA
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Telephone | 617-549-8507
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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 |
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License Number State |
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