Provider Demographics
NPI:1699717959
Name:ELMWOOD HEALTH CENTER INC
Entity type:Organization
Organization Name:ELMWOOD HEALTH CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-751-3800
Mailing Address - Street 1:225 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02907-1461
Mailing Address - Country:US
Mailing Address - Phone:401-272-0600
Mailing Address - Fax:401-454-0818
Practice Address - Street 1:225 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02907-1461
Practice Address - Country:US
Practice Address - Phone:401-272-0600
Practice Address - Fax:401-454-0818
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH CONCEPTS LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-12
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI611313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI415072Medicare Oscar/Certification