Provider Demographics
NPI:1053428185
Name:SAINT ELIZABETH HOME EAST GREENWICH
Entity type:Organization
Organization Name:SAINT ELIZABETH HOME EAST GREENWICH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOROWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-471-6060
Mailing Address - Street 1:ONE SAINT ELIZABETH WAY
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818
Mailing Address - Country:US
Mailing Address - Phone:401-471-6060
Mailing Address - Fax:401-471-6072
Practice Address - Street 1:ONE SAINT ELIZABETH WAY
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818
Practice Address - Country:US
Practice Address - Phone:401-471-6060
Practice Address - Fax:401-471-6072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILTC00728314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7101027OtherEVERCARE
RI405122OtherBLUE CROSS BLUE SHIELD
RI4105010Medicaid
RI7100078OtherUNITED HEALTHCARE
RI7101027OtherEVERCARE