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Organization

CHARLESGATE NURSING CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS LUCILLE MASSEMINO RN,NHA (ADMINISTRATOR)
(401) 861-5858
Entity
Organization

Contact information

Practice address
100 RANDALL ST, PROVIDENCE, RI 02904-2723
(401) 861-5858
(401) 861-2540
Mailing address
100 RANDALL ST, PROVIDENCE, RI 02904-2723
(401) 861-5858
(401) 861-2540

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
LTC00621
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4105052
RI
Enumeration date
10/24/2005
Last updated
04/10/2008
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