Provider Demographics
NPI:1417392705
Name:KAR LITTLE BOX LLC
Entity Type:Organization
Organization Name:KAR LITTLE BOX LLC
Other - Org Name:SILVER CREEK MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CIOCIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-253-3000
Mailing Address - Street 1:7 CREEK LN
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-2401
Mailing Address - Country:US
Mailing Address - Phone:401-253-3000
Mailing Address - Fax:401-254-1289
Practice Address - Street 1:7 CREEK LN
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:RI
Practice Address - Zip Code:02809-2401
Practice Address - Country:US
Practice Address - Phone:401-253-3000
Practice Address - Fax:401-254-1289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility