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General NPI Number Information
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NPI Number | 1750469003
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Entity Type | Organization
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Legal Business Name | SILVER CREEK MANOR, INC
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 11/09/2007
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Provider Practice Location Address
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Address Line | 7 CREEK LN
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City | BRISTOL
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State | RI
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Zip | 02809-2401
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Country | US
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Telephone | 401-253-3000
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Fax | 401-254-1289
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Provider Business Mailing Address
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Address Line | 7 CREEK LN
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City | BRISTOL
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State | RI
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Zip | 02809-2401
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Country | US
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Telephone | 401-253-3000
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Fax | 401-254-1289
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. KIMBERLY A CIOCIOLA
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Credential | NHA
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Telephone | 401-253-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 625
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License Number State | RI
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