Organization · NPI-2
10 Old Dominion Operations, LLC
Assisted Living Facility · Cumberland, RI
NPI number1679132252
StatusActive
Last updated in NPPESJun 7, 2019
Details
- NPI
- 1679132252
- Entity type
- Organization (NPI-2)
- Legal business name
- 10 Old Dominion Operations, LLC
- Organization subpart
- No
- Enumeration date
- Jun 7, 2019
- Last updated
- Jun 7, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | – | – | Yes |
Practice location
10 Old Diamond Hill RdCumberland, RI 02864-4611
Phone 410-333-3393
Mailing address
10 Old Diamond Hill RdCumberland, RI 02864-4611
Phone 410-333-3393
Authorized official
Henry J Vaughn
Reimbursement Analyst
2405956025
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