Organization
SOUTH BAY MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK OHLENDORF (CHIEF FINANCIAL OFFICER (CFO))
(414) 918-5403
Entity
Organization
Contact information
Practice address
1959 KINGSTOWN ROAD, SOUTH BAY RETIREMENT LIVING, SOUTH KINGSTOWN, RI 02879-1608
(401) 789-5880
(401) 783-2880
Mailing address
6737 W WASHINGTON ST, SUITE 2300,, MILWAUKEE, WI 53214
(401) 789-5880
(401) 783-2880
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
RI
313M00000X
Nursing Facility/Intermediate Care Facility
LTC00735
RI
Other
Enumeration date
08/08/2008
Last updated
06/03/2015
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