Organization
EAST BAY AL OPERATOR, LLC
Active
Other names
Anchor Bay at East Providence
Organization subpart
No
Provider details
NPI number
Authorized official
KISHA-GAY JOHNSON (REVENUE ACCOUNTING MANAGER)
(410) 427-2669
Entity
Organization
Contact information
Practice address
1440 WAMPANOAG TRL, RIVERSIDE, RI 02915-1045
(401) 433-5000
Mailing address
1416 CLARKVIEW RD, BALTIMORE, MD 21209-2183
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
N/A
—
Enumeration date
01/03/2019
Last updated
01/03/2019
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