Provider Demographics
NPI:1801478748
Name:HALCYON AT WEST BAY, LLC
Entity type:Organization
Organization Name:HALCYON AT WEST BAY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STACKHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:740-491-8721
Mailing Address - Street 1:2783 W SHORE RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-8659
Mailing Address - Country:US
Mailing Address - Phone:740-491-8721
Mailing Address - Fax:
Practice Address - Street 1:2783 W SHORE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02889-8659
Practice Address - Country:US
Practice Address - Phone:740-491-8721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)