Senior Lifestyle Emerald Limited Partnership

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ALR01475 Issued in RI

Legal business name

SENIOR LIFESTYLE EMERALD LIMITED PARTNERSHIP

Doing business as

Emerald Bay Retirement Living

Practice address

10 Old Diamond Hill Road
Emerald Bay Retirement Living
Cumberland, RI 02864-4634

Phone

(401) 333-3393

Fax

(401) 333-6021

NPI assigned

Mar 12, 2007

Last updated

Jun 3, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark Ohlendorf

Title

Chief Financial Officer (Cfo)

Phone

(414) 918-5403

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Emerald Bay Retirement Living Doing business as

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433289600000",
    "number": "1801928031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6737 W WASHINGTON ST",
            "address_2": "SUITE 2300,",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53214",
            "telephone_number": "401-333-3393",
            "fax_number": "401-333-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 OLD DIAMOND HILL ROAD",
            "address_2": "EMERALD BAY RETIREMENT LIVING",
            "city": "CUMBERLAND",
            "state": "RI",
            "postal_code": "028644634",
            "telephone_number": "401-333-3393",
            "fax_number": "401-333-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR LIFESTYLE EMERALD LIMITED PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2015-06-03",
        "status": "A",
        "authorized_official_last_name": "OHLENDORF",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER (CFO)",
        "authorized_official_telephone_number": "414-918-5403"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "RI",
            "license": "1309",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "RI",
            "license": "ALR01475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EB41712",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emerald Bay Retirement Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael C. Santos, OD, FAAO
• Steven W Santos, O.D.
• Michael J Scampoli
• Cathy J. Schoorens, M.D.
• Wendy E Schwartz, PHD
• Charlotte Ann Senno, RN, GCNC-BC, APRN
• Mini Sharma, APRN, PMHNP-BC
• Hunter Shaw
• Michael Dudley Shaw, MPT
• Sarah Louise Shaw, NP

• Assisted Living Facility in Cumberland, RI
• Providers in Cumberland, 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 Jun 3, 2015; 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.