SH Opco East Bay Manor LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SH OPCO EAST BAY MANOR LLC

Doing business as

East Bay Retirement Living

Practice address

1440 Wampanoag TRL
Riverside, RI 02915-1045

Phone

(401) 433-5000

Fax

(401) 433-4541

NPI assigned

Aug 23, 2011

Organization subpart

Yes

Parent organization

BROOKDALE SENIOR LIVING INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark W Ohlendorf

Title

Assistant Secretary

Phone

(414) 918-5000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• East Bay Retirement Living Doing business as

Part of

Brookdale Senior Living Inc

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314057600000",
    "number": "1659651560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 WAMPANOAG TRL",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029151045",
            "telephone_number": "401-433-5000",
            "fax_number": "401-433-4541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 WAMPANOAG TRL",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029151045",
            "telephone_number": "401-433-5000",
            "fax_number": "401-433-4541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SH OPCO EAST BAY MANOR LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOKDALE SENIOR LIVING INC",
        "enumeration_date": "2011-08-23",
        "last_updated": "2011-08-23",
        "status": "A",
        "authorized_official_last_name": "OHLENDORF",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "414-918-5000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "RI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TBD",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Bay Retirement Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pamela Alida Scalise, PSYD
• Jean M Schayer, LICSW
• Patricia Schneider, APRN
• Senior Lifestyle East Bay Limited Partnership
• Stephanie Yvette Set Guzman, RN
• Ankur Shah, M.D.
• Regina Shannon
• Bethany Leigh Sharpe, PHARM. D.
• Douglas G Shemin, MD
• Mae Shen, MD

• Assisted Living Facility in Riverside, RI
• Providers in Riverside, RI by specialty
• Assisted Living Facility in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.