Organization
CORTLAND PLACE HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NORMAN P AUDINO JR. (OWNER)
(401) 949-3880
Entity
Organization
Contact information
Practice address
20 AUSTIN AVENUE, GREENVILLE, RI 02828
(401) 949-3880
(401) 949-4170
Mailing address
20 AUSTIN AVENUE, GREENVILLE, RI 02828
(401) 949-3880
(401) 949-4170
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
ALR01379
RI
314000000X
Skilled Nursing Facility
LTC00704
RI
314000000X
Skilled Nursing Facility
Primary
—
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4105123
—
RI
01
—
5432, 402017, 5309
RHODE ISLAND BLUECROSS
RI
01
—
7109172
UNITED HEALTHCARE
—
Enumeration date
03/23/2007
Last updated
06/13/2018
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