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Contact Information

SHADY ACRES, INC.
415 GARDNER RD
WEST KINGSTON, RI02892-1047
 Phone: 401-295-8520
 Fax: 401-294-1050
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
Indicates primary specialty

NPI Profile & details for SHADY ACRES, INC.

NPI Number 1346234135
LBN Legal business name SHADY ACRES, INC.
Authorized official CHARLES MIGA - (PRESIDENT/ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 09/07/2005
Last updated 09/10/2014 - About 12 years ago
Identifiers
RI License # 608
RI Medicaid 4105107
RI Other 402416 BLUE CHIP
RI Other 71-0005 UNITED HEALTHCARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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