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General NPI Number Information
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NPI Number | 1316226764
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Entity Type | Organization
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Legal Business Name | S H OPCO GREENWICH BAY MANOR LLC
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Dates
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Enumeration Date | 08/16/2011
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Last Update Date | 08/17/2011
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Provider Practice Location Address
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Address Line | 945 MAIN ST
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City | EAST GREENWICH
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State | RI
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Zip | 02818-3150
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Country | US
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Telephone | 401-885-3334
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Fax | 401-885-1260
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Provider Business Mailing Address
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Address Line | 945 MAIN ST
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City | EAST GREENWICH
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State | RI
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Zip | 02818-3150
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Country | US
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Telephone | 401-885-3334
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Fax | 401-885-1260
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Authorized Official
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Title or Position | ASSISTANT SECRETARY
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Name | MARK W OHLENDORF
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Credential |
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Telephone | 414-918-5000
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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 | PENDING
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License Number State | RI
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