Organization
LAKEVIEW OCEAN STATE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS SLOVER (ADMINISTRATOR)
(603) 539-7451
Entity
Organization
Contact information
Practice address
4219 S COUNTY TRL, CHARLESTOWN, RI 02813-3628
(401) 364-8719
Mailing address
244 HIGH WATCH RD, EFFINGHAM, NH 03882-8336
(603) 539-7451
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LO58163
—
RI
Enumeration date
03/12/2007
Last updated
07/09/2009
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