Provider Demographics
NPI:1568531325
Name:THE CLIPPER HOME INC.
Entity Type:Organization
Organization Name:THE CLIPPER HOME INC.
Other - Org Name:THE CLIPPER HOME INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-678-9755
Mailing Address - Street 1:161 POST RD
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-2673
Mailing Address - Country:US
Mailing Address - Phone:401-322-8081
Mailing Address - Fax:401-322-0910
Practice Address - Street 1:161 POST RD
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-2673
Practice Address - Country:US
Practice Address - Phone:401-322-8081
Practice Address - Fax:401-322-0910
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APPLE HEALTH CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-07
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI696314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI4105120Medicaid
RI415120Medicare Oscar/Certification
RI41-5120Medicare UPIN