Organization
100 WAMPANOAG TRAIL OPERATING COMPANY, LLC
Active
Other names
Elderwood at Riverside
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY RUBIN (CO-CHIEF EXECUTIVE OFFICER)
(716) 817-5075
Entity
Organization
Contact information
Practice address
100 WAMPANOAG TRL, RIVERSIDE, RI 02915-3736
(401) 438-4275
(401) 438-8093
Mailing address
500 SENECA ST STE 100, BUFFALO, NY 14204-1963
(716) 633-3900
(646) 924-0502
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/26/2013
Last updated
01/19/2023
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