Provider Demographics
NPI:1124170444
Name:UNITED METHODIST RETIREMENT CENTER
Entity type:Organization
Organization Name:UNITED METHODIST RETIREMENT CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-438-7210
Mailing Address - Street 1:40 IRVING AVE
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-2309
Mailing Address - Country:US
Mailing Address - Phone:401-438-4456
Mailing Address - Fax:401-438-1206
Practice Address - Street 1:40 IRVING AVE
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-2309
Practice Address - Country:US
Practice Address - Phone:401-438-4456
Practice Address - Fax:401-438-1206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIALR01372310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIUM44451Medicaid