Organization
BURRILLVILLE NURSING HOME INC
Active
Other names
Pine Grove Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS LLOYD RYAN (PRESIDENT OWNER)
(401) 568-3091
Entity
Organization
Contact information
Practice address
999 S MAIN ST, PASCOAG, RI 02859-3522
(401) 568-3091
(401) 568-8070
Mailing address
999 S MAIN ST, PASCOAG, RI 02859-3522
(401) 568-3091
(401) 568-8070
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
601
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4105099
—
RI
Enumeration date
10/14/2005
Last updated
08/22/2020
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