=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356306757
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OAKLAND GROVE ASSOCIATES LP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/19/2006
-----------------------------------------------------
Last Update Date | 02/16/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 560 CUMBERLAND HILL RD
-----------------------------------------------------
City | WOONSOCKET
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02895-5635
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-769-0800
-----------------------------------------------------
Fax | 401-766-3661
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 560 CUMBERLAND HILL RD
-----------------------------------------------------
City | WOONSOCKET
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02895-5635
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-769-0800
-----------------------------------------------------
Fax | 401-766-3661
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOLE MANAGER
-----------------------------------------------------
Name | LAWRENCE G. SANTILLI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 860-751-3900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number | LTC00718
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------