Provider Demographics
NPI:1629123021
Name:SAINT ELIZABETH ASSISTED LIVING, L.P.
Entity Type:Organization
Organization Name:SAINT ELIZABETH ASSISTED LIVING, L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-490-4646
Mailing Address - Street 1:109 MELROSE ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02907-1856
Mailing Address - Country:US
Mailing Address - Phone:401-490-4646
Mailing Address - Fax:401-490-4537
Practice Address - Street 1:109 MELROSE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02907-1856
Practice Address - Country:US
Practice Address - Phone:401-490-4646
Practice Address - Fax:401-490-4537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIALR01425310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility