Provider Demographics
NPI:1508160417
Name:ONE LANTERN SENIOR LIVING INC.
Entity Type:Organization
Organization Name:ONE LANTERN SENIOR LIVING INC.
Other - Org Name:AQUIDNECK PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-779-7608
Mailing Address - Street 1:125 QUAKER HILL LN
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871-4072
Mailing Address - Country:US
Mailing Address - Phone:401-683-0725
Mailing Address - Fax:
Practice Address - Street 1:125 QUAKER HILL LN
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-4072
Practice Address - Country:US
Practice Address - Phone:401-683-0725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ONE LANTERN SENIOR LIVING INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility