- Enrollment id
- O20210318000081
- Enrollment state
- RI
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1053925024
- Multiple npi flag
- N
- Ccn
- 415035
- Associate id
- 8224445226
- Organization name
- LINCOLNWOOD OPERATOR LLC
- Doing business as name
- LINCOLNWOOD REHABILITATION AND HEALTHCARE CENTER
- Incorporation date
- 2020-05-15
- Incorporation state
- RI
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- LINCOLNWOOD REHABILITATION AND HEALTHCARE CENTER
- Affiliation entity name
- MARQUIS HEALTH SERVICES
- Affiliation entity id
- 336
- Address line 1
- 610 SMITHFIELD RD
- City
- NORTH PROVIDENCE
- State
- RI
- Zip code
- 029043820