NPI 1366997082 · live from the CMS NPI Registry
Shady Acres Operations Assoc LLC
Skilled Nursing Facility in West Kingston, RI. National Provider Identifier 1366997082, active.
NPI record
| NPI | 1366997082 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 415 Gardner Rd, West Kingston, RI 02892 |
| Practice phone | 401-295-8520 |
| Mailing address | 4770 White Plains Rd, Bronx, NY 10470 |
| Enumerated | August 23, 2016 |
| Last updated | October 5, 2016 |
| Authorized official | Kenneth Rozenberg, Member |
| Other names | Kingston Center For Rehabilitation And Health Care |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | LTC00804 (RI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.