Organization
BANNISTER NURSING CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL A. MANCINI (ADMINISTRATOR)
(401) 521-9600
Entity
Organization
Contact information
Practice address
135 DODGE ST, PROVIDENCE, RI 02907-2210
(401) 521-9600
(401) 274-3233
Mailing address
135 DODGE ST, PROVIDENCE, RI 02907-2210
(401) 521-9600
(401) 274-3233
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
LTC00600
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4105038
—
RI
01
—
5005-0
BLUE CROSS
RI
Enumeration date
03/28/2007
Last updated
08/22/2020
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