Provider Demographics
NPI:1437114436
Name:SAINT ELIZABETH AT HOME CORP
Entity type:Organization
Organization Name:SAINT ELIZABETH AT HOME CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:RUMOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-751-9660
Mailing Address - Street 1:249 WICKENDEN ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4422
Mailing Address - Country:US
Mailing Address - Phone:401-751-9660
Mailing Address - Fax:401-831-2157
Practice Address - Street 1:249 WICKENDEN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4422
Practice Address - Country:US
Practice Address - Phone:401-751-9660
Practice Address - Fax:401-831-2157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI2204163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI4107038Medicaid
RI5833-7OtherBLUE CROSS
RI417038Medicare Oscar/Certification