LIFE CARE CENTERS OF AMERICA, INC (NPI# 1316907843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316907843 |
| Entity Type | Organization |
| Organization Name | LIFE CARE CENTERS OF AMERICA, INC |
| Other Organization Name | EVERGREEN HOUSE HEALTH CENTER |
| Practice Address |
1 Evergreen Dr East Providence RI 02914-1503 |
| Mailing Address |
3001 Keith St Nw Cleveland TN 37312-3713 |
| Practice Telephone | 4014383250 |
| Practice Fax Number | 4014384813 |
| Mailing Telephone | 4234735751 |
| Mailing Fax Number | 4233398342 |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2008-02-12 |
| Authorized Official Name | CINDY S. CROSS (ASSISTANT SECRETARY) |
| Authorized Official Telephone | 4234735867 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | LTC00686 | RI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | 653 | 05 |
| Other Name | Type Code |
|---|---|
| Evergreen House Health Center | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | LIFE CARE CENTERS OF AMERICA, INC. | 3570 Keith St Nw, Cleveland, TN 37312 |
| Connecticut Business Registrations | LIFE CARE CENTERS OF AMERICA, INC. | 114 South Main St, Bel Air, MD 21014 |
| Washington State Corporations | LIFE CARE CENTERS OF AMERICA, INC. | 3570 Keith St Nw, Cleveland, TN 37312-4309 |
| Oregon Corporations, Companies and Business Names | LIFE CARE CENTERS OF AMERICA, INC. | 3570 Keith Street Nw, Cleveland, TN 37311 |
| Massachusetts Corporations | LIFE CARE CENTERS OF AMERICA, INC. | 3570 Keith St.,n.w., Cleveland, TN 37312 |
| Street Address |
1 EVERGREEN DR |
| City | EAST PROVIDENCE |
| State | RI |
| Zip Code | 02914-1503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568843126 | Donna Marie Kaba | Nurse Practitioner | 1 Evergreen Dr, East Providence, RI 02914-1506 | 2015-06-09 |
| 1235448739 | Frank N Morosky | Physical Therapist | 1 Evergreen Dr, East Providence, RI 02914-1506 | 2010-09-30 |
| 1174851109 | Patricia Anne Ryan | Physical Therapist | 1 Evergreen Dr, East Providence, RI 02914-1506 | 2009-12-02 |
| 1730324831 | Samantha K Brown | Physical Therapist | 1 Evergreen Dr, East Providence, RI 02914-1503 | 2008-12-04 |
| 1942405147 | Robert William Martin | Physical Therapy Assistant | 1 Evergreen Dr, East Providence, RI 02914-1503 | 2007-06-18 |
| 1154523256 | Denise Conway | Speech-Language Pathologist | 1 Evergreen Dr, East Providence, RI 02914-1503 | 2007-06-01 |
| 1588875983 | Pamela J Fox | Occupational Therapy Assistant | 1 Evergreen Dr, East Providence, RI 02914-1503 | 2007-05-25 |
| 1245441930 | Kirt Carl Van | Occupational Therapy Assistant | 1 Evergreen Dr, East Providence, RI 02914-1503 | 2007-05-24 |
| 1215061650 | Shirley Faye Goudie | Physical Therapist | 1 Evergreen Dr, East Providence, RI 02914-1503 | 2007-03-16 |
| 1053444109 | Dino B Iacobo | Occupational Therapist | 1 Evergreen Dr, East Providence, RI 02914-1503 | 2007-03-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457988198 | Sean C. Duffy | Massage Therapist | 231 Warren Ave., East Providence, RI 02914 | 2020-03-24 |
| 1457905606 | Jeanine Le-kreuzer, Lmhc | Clinic/Center | 3421 Pawtucket Ave, East Providence, RI 02914 | 2019-07-26 |
| 1881113983 | Megan Grace Fitzpatrick | Student in an Organized Health Care Education/Training Program | 51 Milburn Rd, East Providence, RI 02914 | 2017-09-11 |
| 1265719660 | Hilary Elise Bicknell | Physical Therapist | 927 B Warren Ave, East Providence, RI 02914 | 2011-11-14 |
| 1346549037 | Amanda M Hope | Occupational Therapist | 2680 Pawtucket Ave, East Providence, RI 02914 | 2011-03-21 |
| 1780993824 | Shannon Hayes | Physical Therapist | 400 Massaoit Ave, East Providence, RI 02914 | 2010-10-06 |
| 1053623538 | Ricardo Rafael Correa Marquez | Internal Medicine | 900 Warren Avenue, Suite 300, East Providence, RI 02914 | 2010-07-13 |
| 1013231570 | Michael Seidler | Internal Medicine | 20 Catamore Blvd., East Providence, RI 02914 | 2010-03-26 |
| 1053543405 | Ray Rezania | Dentist | 1055 South Broadway, East Providence, RI 02914 | 2009-08-19 |
| 1144464587 | John F Maynard | Urology | Metacomet Office Park, 450 Veterans Parkway, East Providence, RI 02914 | 2009-04-29 |
| Find all providers in zip 02914 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831443779 | Athena Orchard View LLC | Skilled Nursing Facility | 135 Tripps Lane, East Providence, RI 02915-3017 | 2012-10-30 |
| 1366561631 | Tockwotton Home | Skilled Nursing Facility | 500 Waterfront Drive, East Providence, RI 02914-5047 | 2007-03-28 |
| 1639222367 | Linn Health & Rehabilitation | Skilled Nursing Facility | 30 Alexander Ave, East Providence, RI 02914-2309 | 2007-01-18 |
| 1043258932 | Harris Health Center, LLC | Skilled Nursing Facility | 833 Broadway, East Providence, RI 02914-3722 | 2006-06-03 |
| 1235112921 | Eastgate Nursing and Recovery Center Inc. | Skilled Nursing Facility | 198 Waterman Ave, East Providence, RI 02914-3523 | 2005-11-28 |
| 1053313791 | Waterview Ri Snf, LLC | Skilled Nursing Facility | 1275 S Broadway, East Providence, RI 02914-4932 | 2005-08-12 |
| 1508864646 | Orchard View Manor, Inc | Skilled Nursing Facility | 135 Tripps Ln, East Providence, RI 02915-3017 | 2005-07-12 |
| 1457610552 | 198 Waterman Avenue LLC | Skilled Nursing Facility | 198 Waterman Ave, East Providence, RI 02914-3523 | 2012-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952840381 | New England Premier Healthcare | Skilled Nursing Facility | 262 Poplar St, Woonsocket, RI 02895-3747 | 2017-02-17 |
| 1174986608 | Theodore J Hardgrove | Skilled Nursing Facility | 174 Woodward Rd, Providence, RI 02904-1720 | 2016-04-01 |
| 1891109336 | Senior Lifestyle Sakonnet Bay Limited Partnership | Skilled Nursing Facility | 1215 Main Rd, Tiverton, RI 02878-4246 | 2014-06-12 |
| 1477971893 | Ch-oak Hill LLC | Skilled Nursing Facility | 544 Pleasant St, Pawtucket, RI 02860-5726 | 2014-04-02 |
| 1144643586 | Nicole Morin | Skilled Nursing Facility | 180 Bailey St, Woonsocket, RI 02895-6302 | 2014-01-21 |
| 1093057143 | 100 Wampanoag Trail Operating Company, LLC | Skilled Nursing Facility | 100 Wampanoag Trl, Riverside, RI 02915-3736 | 2013-03-26 |
| 1558658963 | Coventry Skilled Nursing and Rehab | Skilled Nursing Facility | 10 Woodland Drive, Coventry, RI 02816 | 2011-07-06 |
| 1679874135 | 981 Kings Town Road Operating Company, LLC | Skilled Nursing Facility | 55 Scallop Shell Way, Peace Dale, RI 02879-3045 | 2010-11-15 |
| 1750533527 | Angela Niles | Skilled Nursing Facility | 6 Luther St, Johnston, RI 02919-6129 | 2008-10-10 |
| 1740432517 | Kimberly Lizotte | Skilled Nursing Facility | 642 River Rd, Lincoln, RI 02865-1406 | 2008-10-10 |
| Find all providers with the same taxonomy | ||||
| City | EAST PROVIDENCE |
| Zip Code | 02914 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.