Provider Demographics
NPI:1679919203
Name:WOONSOCKET HOUSING AUTHORITY
Entity Type:Organization
Organization Name:WOONSOCKET HOUSING AUTHORITY
Other - Org Name:ST. GERMAIN MANOR
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:KULIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-767-8000
Mailing Address - Street 1:679 SOCIAL ST
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-2026
Mailing Address - Country:US
Mailing Address - Phone:401-767-8000
Mailing Address - Fax:401-767-8019
Practice Address - Street 1:429 E SCHOOL ST
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-1377
Practice Address - Country:US
Practice Address - Phone:401-435-3331
Practice Address - Fax:401-438-0023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIALR01484310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility