Organization
SAINT ELIZABETH MANOR EAST BAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH RUSSELL (ADMINISTRATOR)
(401) 253-2300
Entity
Organization
Contact information
Practice address
1 DAWN HILL RD, BRISTOL, RI 02809-3903
(401) 253-2300
(401) 254-1919
Mailing address
1 DAWN HILL RD, BRISTOL, RI 02809-3903
(401) 253-2300
(401) 254-1919
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
LTC00667
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
402364
BLUECHIP PROVIDER NUMBER
RI
01
—
50407
BC/BS
RI
05
—
6996931
—
MA
05
—
SE48598
—
RI
Enumeration date
12/05/2005
Last updated
08/15/2007
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