| NPI | 1366442899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE F TAVARES Administrator 401-272-7127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: RI RI 642) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: RI RI 642) |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2020-08-22 |