Organization
SCANDINAVIAN HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA TUCKER (ADMINISTRATOR)
(401) 461-1433
Entity
Organization
Contact information
Practice address
1811 BROAD ST, CRANSTON, RI 02905-3533
(401) 461-1433
(401) 461-4005
Mailing address
1811 BROAD STREET, CRANSTON, RI 02905
(401) 461-1433
(401) 461-4005
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
00390
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
405363
BLUE CHIP PROVIDER NUMBER
RI
05
—
4105051
—
RI
01
—
54375
BLUE CROSS PROVIDER NUMBE
RI
01
—
740800
UNITED HEALTH PROVIDER NU
RI
Enumeration date
07/08/2006
Last updated
01/23/2008
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