Provider Demographics
NPI:1669589800
Name:HARKEN INC
Entity type:Organization
Organization Name:HARKEN INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:S
Authorized Official - Last Name:KENOIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-568-2549
Mailing Address - Street 1:14 ROCK AVE
Mailing Address - Street 2:PO BOX 152
Mailing Address - City:PASCOAG
Mailing Address - State:RI
Mailing Address - Zip Code:02859-0152
Mailing Address - Country:US
Mailing Address - Phone:401-568-2549
Mailing Address - Fax:401-568-6085
Practice Address - Street 1:14 ROCK AVE
Practice Address - Street 2:
Practice Address - City:PASCOAG
Practice Address - State:RI
Practice Address - Zip Code:02859-0152
Practice Address - Country:US
Practice Address - Phone:401-568-2549
Practice Address - Fax:401-568-6085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI362314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI415045Medicare ID - Type Unspecified