EAST BAY AL OPERATOR, LLC (NPI# 1336612357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336612357 |
| Entity Type | Organization |
| Organization Name | EAST BAY AL OPERATOR, LLC |
| Practice Address |
1440 Wampanoag Trl Riverside RI 02915-1045 |
| Mailing Address |
1416 Clarkview Rd Baltimore MD 21209-2183 |
| Practice Telephone | 4014335000 |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2019-01-03 |
| Authorized Official Name | KISHA-GAY JOHNSON (REVENUE ACCOUNTING MANAGER) |
| Authorized Official Telephone | 4104272669 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| N/A | NA | 01 |
| Other Name | Type Code |
|---|---|
| Anchor Bay at East Providence | Doing Business As Name - Organization |
| Street Address |
1440 WAMPANOAG TRL |
| City | RIVERSIDE |
| State | RI |
| Zip Code | 02915-1045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114059318 | Senior Lifestyle East Bay Limited Partnership | Assisted Living Facility | 1440 Wampanoag Trl, Riverside, RI 02915-1045 | 2007-03-12 |
| 1659651560 | Sh Opco East Bay Manor LLC | Assisted Living Facility | 1440 Wampanoag Trl, Riverside, RI 02915-1045 | 2011-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881101335 | Brown Medicine | Clinic/Center | 62-68 Amaral Street, East Providence, RI 02915 | 2018-01-05 |
| 1093245391 | Robyn Lee Cranson | Pharmacist | 1086 Willet Ave, Rite Aid Pharmacy, Riverside, RI 02915 | 2017-06-19 |
| 1548703622 | Rebecca Leigh Bejma | Registered Nurse | 100 Bullocks Ave, East Providence, RI 02915 | 2016-11-22 |
| 1568833408 | Riverside Smiles Theodore I Goldberg, Dmd PC & Associates | Dentist | 250 Wampanoag Trail Suite 103, Riverside, RI 02915 | 2015-10-19 |
| 1003165796 | Sandra Cairo | Registered Nurse | 125 Bayview Ave, Riverside, RI 02915 | 2012-09-10 |
| 1487916136 | East Bay Community Action Program | Peer Specialist | 100 Bullocks Point, Riverside, RI 02915 | 2012-06-08 |
| 1497041453 | Bethany Marie Goldberg | Nurse Practitioner | 38 Amaral Street, Riverside, RI 02915 | 2011-06-28 |
| 1790078947 | Matthew Lynch | Internal Medicine | 375 Wampanoag Trl Ste 302a, Riverside, RI 02915 | 2011-05-20 |
| 1679866206 | Jill Stone | Occupational Therapist | 57 Euclid Ave, East Providence, RI 02915 | 2011-05-16 |
| 1770884462 | Kristin F. Cadieux | Nurse Practitioner | 375 Wampanoag Trl Ste 102, Riverside, RI 02915 | 2010-11-11 |
| Find all providers in zip 02915 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588280788 | Yenny M Vieyra Aviles | Assisted Living Facility | 3879 Lafayette St, Riverside, CA 92503-3821 | 2020-06-23 |
| 1326672973 | Blessed Elder Care Inc | Assisted Living Facility | 5041 Sierra St, Riverside, CA 92504-2260 | 2020-02-22 |
| 1518504786 | Faith Hope and Love Assisted Living, Inc. | Assisted Living Facility | 5505 Via San Jacinto, Riverside, CA 92506-3652 | 2019-12-05 |
| 1477037299 | California Home for The Adult Deaf | Assisted Living Facility | 3615 Crowell Ave, Riverside, CA 92504-3549 | 2018-09-18 |
| 1790265650 | Juan Cornell | Assisted Living Facility | 1622 Palermo Dr, Riverside, CA 92507-2393 | 2018-08-20 |
| 1467961755 | Daniela Popa | Assisted Living Facility | 10820 Calle Bella, Riverside, CA 92503 | 2017-09-29 |
| 1972029486 | Fern Home 1 LLC | Assisted Living Facility | 3875 Megginson Ln, Riverside, CA 92503-3425 | 2017-08-16 |
| 1255755237 | Caloaks Care Group Inc | Assisted Living Facility | 3891 Polk St, Riverside, CA 92505-1703 | 2014-02-11 |
| 1386965424 | Senior Focus Residential Care | Assisted Living Facility | 871 Via Mindi, Riverside, CA 92506-3642 | 2010-06-11 |
| 1780913475 | Summerville At Cobbco, Inc. | Assisted Living Facility | 5881 El Palomino Dr, Riverside, CA 92509-7006 | 2009-12-09 |
| Find all providers in RIVERSIDE | ||||
Please comment or provide details below to improve the information on EAST BAY AL OPERATOR, LLC.
| 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.