Shi-III Wrentham LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SHI-III WRENTHAM LLC

Practice address

30 Ledgeview Way
Attn: Executive Director Or Dba
Wrentham, MA 02093

Phone

(774) 210-8108

Fax

(774) 847-9725

NPI assigned

Nov 7, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Raymond Dioguardi

Title

Coo/Cfo

Phone

(516) 496-1505

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596499200000",
    "number": "1811465974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 JERICHO QUADRANGLE STE 142",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117532702",
            "telephone_number": "516-496-1505",
            "fax_number": "516-496-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 LEDGEVIEW WAY",
            "address_2": "ATTN: EXECUTIVE DIRECTOR OR DBA",
            "city": "WRENTHAM",
            "state": "MA",
            "postal_code": "02093",
            "telephone_number": "774-210-8108",
            "fax_number": "774-847-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHI-III WRENTHAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-07",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A",
        "authorized_official_last_name": "DIOGUARDI",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "COO/CFO",
        "authorized_official_telephone_number": "516-496-1505",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen J Sebastian, M.D.
• Seed of Care
• Sein H. Siao, DMD & Associates, P.C.
• Samantha L Shaughnessy, LICSW
• Kaylan Shaw, LPN
• Shriver Clinical Services
• Sein H. Siao, DMD
• Stephen Signes, RPH
• Kathleen Marie Slack, RN, MSN, PMHNP
• Andre Eugene St Germain, DMD MSCD

• Assisted Living Facility in Wrentham, MA
• Providers in Wrentham, MA by specialty
• Assisted Living Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.