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General NPI Number Information
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NPI Number | 1538286679
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Entity Type | Organization
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Legal Business Name | SHAKE-A-LEG, INC.
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 850 AQUIDNECK AVE SUITE 6-A
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City | MIDDLETOWN
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State | RI
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Zip | 02842-7244
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Country | US
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Telephone | 401-849-8898
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Fax | 401-848-9072
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Provider Business Mailing Address
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Address Line | 850 AQUIDNECK AVE SUITE 6-A
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City | MIDDLETOWN
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State | RI
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Zip | 02842-7244
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Country | US
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Telephone | 401-849-8898
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Fax | 401-848-9072
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MR. JAMES A CHARNLEY
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Credential |
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Telephone | 401-849-8898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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