100 Wampanoag Trail Operating Company, LLC
NPI #1093057143 in Riverside, Rhode Island
Provider Information
- NPI Number
- 1093057143
- Entity Type
- Organization
- Organization Name
- 100 Wampanoag Trail Operating Company, LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Mar 26, 2013
- Last Updated
- Jan 19, 2023
Practice Location
- Address
- 100 WAMPANOAG TRL
- City
- Riverside
- State
- Rhode Island
- ZIP Code
- 02915-3736
- Phone
- (401) 438-4275
Authorized Official
- Name
- DR. JEFFREY RUBIN
- Title
- CO-CHIEF EXECUTIVE OFFICER
- Phone
- (716) 817-5075
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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