Organization Active NPI

Scandinavian Home Inc

  • Skilled Nursing Facility
  • Cranston, RI
National Provider Identifier
1922031665
Registry record updated Jan 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
00390 Issued in RI
Legal business name
SCANDINAVIAN HOME INC
Practice address
1811 Broad St
Cranston, RI 02905-3533
Phone
(401) 461-1433
Fax
(401) 461-4005
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2008

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

Authorized official

Name
Mrs. Linda Tucker
Title
Administrator
Phone
(401) 461-1433

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 00390 RI Primary

Addresses

Primary practice location

1811 Broad St
Cranston, RI 02905-3533

Mailing address

1811 Broad Street
Cranston, RI 02905
Phone (401) 461-1433

Other identifiers 4

IdentifierTypeStateIssuer
740800OtherRIUNITED HEALTH PROVIDER NU
405363OtherRIBLUE CHIP PROVIDER NUMBER
54375OtherRIBLUE CROSS PROVIDER NUMBE
4105051MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071207000514 RI Part A Provider - Skilled Nursing Facility 4981793320 Practice locations: Cranston, RI

Skilled nursing facility certification: CCN 415051

Legal name
SCANDINAVIAN HOME INC
Certification status
Active
Provider type (POS)
Nursing home โ€“ SNF/NF dual certification
Participating since
Jul 1, 1977
Last certification
Nov 7, 2024
Beds
74
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
May 12, 1930 in RI
Enrollment address
1811 Broad Street
Cranston, RI 02905-3533
Nursing home name
SCANDINAVIAN HOME INC

Care Compare: Nursing home

Medicare Care Compare
Listed as
Scandinavian Home IncCCN 415051 ยท All quality measures
Overall star rating
4 of 5
Health inspections
5 of 5
Staffing
1 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jul 1, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
74

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Scandinavian Home Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Donald Forster Individual Corporate OfficerBoard Member Jun 1, 2020
Colette Silverman Individual Corporate OfficerExecutive Director Jan 1, 2019
W-2 Managing EmployeeExecutive Director Jan 1, 2019 100%
Paul a Swanson Individual Corporate OfficerBoard Vice President Jun 1, 2020
Thomas Pearson Individual Corporate OfficerBoard Member Jun 1, 2020
Jean Larkin Individual Corporate OfficerBoard Member Jun 1, 2020
Ronald S Ohsberg Individual Corporate OfficerBoard Member Jun 1, 2020
Taiwo Sodipo Individual W-2 Managing EmployeeAdministrator Jul 1, 2019
Leif Reslow Individual Corporate OfficerBoard President Jun 1, 2020
Joel Johnson Individual Corporate OfficerBoard Member Jun 1, 2020
Julie Carroccia Individual Corporate OfficerBoard Member Jun 1, 2020
Margaret Mock Individual Corporate OfficerBoard Secretary Jun 1, 2020
Doris Connor Individual Corporate DirectorBoard Treasurer Jun 1, 2020
Andrew Nault Individual Corporate OfficerBoard Member Jun 1, 2020
Katherine Desimone Individual Corporate OfficerBoard Member Jun 1, 2020

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201046400000",
    "number": "1922031665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 BROAD STREET",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "02905",
            "telephone_number": "401-461-1433",
            "fax_number": "401-461-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 BROAD ST",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029053533",
            "telephone_number": "401-461-1433",
            "fax_number": "401-461-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCANDINAVIAN HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2008-01-23",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-461-1433",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "RI",
            "license": "00390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH PROVIDER NU",
            "identifier": "740800",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP PROVIDER NUMBER",
            "identifier": "405363",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "54375",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4105051",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.