Organization
70 GILL AVENUE OPERATIONS LLC
Active
Other names
Pawtucket Skilled Nursing and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T BERG (CORPORATE OFFICER)
(505) 468-4742
Entity
Organization
Contact information
Practice address
70 GILL AVE, PAWTUCKET, RI 02861-4315
(401) 722-7900
(401) 723-9670
Mailing address
70 GILL AVE, PAWTUCKET, RI 02861-4315
(401) 722-7900
(401) 723-9670
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
LTC00736
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GA75165
—
RI
Enumeration date
10/02/2008
Last updated
07/23/2020
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